[Cimetidine and tripotassium-dicitrato bismuthate (Duosol) in chronic duodenal ulcer]. / Cimétidine et bismuthate dicitrato-tripotassique (Duosol) dans l'ulcère duodénal chronique.

In an open study, 40 patients with duodenal ulcer of several years' standing were treated for relapse with either TDB (De-Nol) or cimetidine. No difference in the relapse rate was observed during the subsequent 12 months. Analysis of the data in relation to smoking habits did, however, reveal an advantage (p less than 0.05) for non-smokers during the first 6 months.

[Intestinal lactase and milk consumption before and after gastrectomy]. / Lactase intestinale et consommation de lait avant et après gastrectomie.

Intestinal lactase assays before and after a Billroth II procedure for chronic duodenal ulcer did not reveal a significant difference. Postoperative lactose intolerance is due to the loss of pyloric function, causing entrance of lactose into the jejunum at a rate exceeding the hydrolytic capacity of the mucosa if the lactase level is low.

[The effect of lactitol on the production of expired hydrogen in normal subjects]. / Effet du lactitol sur la production d'hydrogène expiré chez l'homme normal.

In man, unabsorbed disaccharide lactitol is fermented by colonic flora with an H2 breath production proportional to the absorbed quantity. The osmolality of the ingested solution is without effect either on the oro-cecal transit time and the time of H2 peak, or on the output and peak value of H2 expired. The intestinal symptoms seemed less prominent with slighter osmolality. The beginning of H2 production and the amount of H2 recorded varied widely between different subjects and in the same subject. It is thus important to consider this variability when measuring transit time and evaluating the amount of unabsorbed sugar. The comparison between two analogous doses of lactitol and lactulose (Duphalac) shows lower H2 production with lactulose, but clinical symptoms are slightly more pronounced. The glycemic peak was significantly higher for lactulose than for lactitol.

Trehalase deficiency. Prevalence and relation to single-cell protein food.

Perspectives in nutrition suggest a greater use of single-cell proteins in the future. The problems of a high purine content and of potential allergens have been solved by technology. The single-cell proteins may contain trehalose, the absorption of which by the human intestine necessitates prior hydrolysis by trehalase, a specific brush-border disaccharidase. The enzymatic analysis of 100 intestinal biopsies discovered 2 cases of very low trehalase level, with an expected clinical intolerance to even small doses of trehalose. It is concluded that tolerance to high doses of trehalose should be excellent in about 98% of healthy people.

[Endoscopic polypectomy in the early diagnosis of colonic carcinoma]. / La polypectomie endoscopique dans le diagnostic précoce du carcinome colique.

281 colonic polypectomies, some of which were incomplete, were performed in 202 patients, revealing the presence of 19 (6.8%) non-adenomatous polyps, 218 (77.6%) benign adenomas, 23 (8.2%) adenomas with superficial carcinoma, 12 (4.3%) adenomas with invasive carcinoma and 9 (3.2%) polypoid carcinomas. Malignant adenomas are found in patients of 30 and over, being 3.5 times more frequent when the polyp has villous patterns. Their incidence increases with the diameter of the poly. 21 patients (12.5%) were submitted to further surgery on the basis of endoscopic or histological data. The significance of endoscopic polypectomy is discussed.

Significance of duodenal disaccharidases. A comparative study of duodenal and jejunal values.

Endoscopic biopsies at the inferior duodenal flexure from 36 patients were assayed for disaccharidases. Comparative studies in 8 patients were carried out from this location and from the duodenojejunal flexure. 16 patients with lactase values under 20 U/g protein and normal histology also underwent a lactose tolerance test. Evidence is presented that the easily performed duodenal biopsies give the same information as those from the angle of Treitz, at a level about 40% under the latter. Tolerance to lactose was in close relation with the lactase level in 16 patients, the limit being at about 5 U/g protein.

[Diagnosis of lactase deficiency with the expired hydrogen (H2) test]. / Diagnostic des déficits en lactase par le test de l'hydrogène (H2) expiré.

To determine the sensitivity and specificity of breath hydrogen (H2) in detecting lactase deficiency, breath H2 collected by end-expiratory sampling and capillary blood glucose were measured after ingestion of 50 g of lactose in 36 patients with biopsy-proved isolated lactase deficiency, 42 with normal lactase activity and 6 with lactase deficiency secondary to mucosal lesions. All patients had digestive symptoms clinically compatible with lactose malabsorption. The maximum increase in breath H2 concentration was more than 1.1 mumol/l (25 ppm) in all patients with isolated lactase deficiency, and less than 0.88 mumol/l (20 ppm) in 88% of patients with normal lactase activity; there were 5 false-positive results, attributed in one case to small bowel colonization and in another case to rapid transit after gastric surgery. Secondary lactase deficiency was accurately detected by neither breath H2 nor blood glucose.

[Exhaled hydrogen test in the detection of lactase deficiency]. / Test de l'hydrogène expiré dans la détection des hypolactasies.

To determine the validity of breath H2 measurements in detecting lactase deficiency, capillary blood glucose and breath H2 were measured after ingestion of 50 g lactose in 34 patients with abdominal symptoms or diarrhea. 18 patients had biopsy-proven lactase deficiency and 16 normal lactase activity. Blood glucose determination produced 2 false-positive results while breath H2 measurements provided 2 false-negative and 4 false-positive results.

[Ranitidine therapy of duodenal ulcer: comparison of once-a-day and twice-a-day administration. A Swiss multicenter double-blind study]. / Ranitidintherapie des Ulcus duodeni: Vergleich der zweimaligen und der einmaligen Applikation. Eine multizentrische Schweizer Doppeltblindstudie.

In a Swiss multicenter double-blind trial ranitidine was given in doses of 300 mg nocte and 150 mg b.d. for the treatment of duodenal ulcer. Ninety-seven patients with endoscopically proven ulcer were treated for four, and in cases of non-healing for eight, weeks. Cumulative healing rates with 300 mg and 2 X 150 mg were 77% and 78% after four weeks and 90% and 94% after eight weeks respectively. 60 and 65% of the patients were asymptomatic after four weeks. Smoking did not adversely affect healing. Thus, ranitidine in a dose of 300 mg nocte is as effective as ranitidine in a dose of 150 mg b.d. in the treatment of duodenal ulcer.