The cephalogastric phase of the pancreatic response to food in the dog.

We studied post-meal pancreatic secretion and gastrin release in conscious dogs with duodenal Thomas cannulas. Normal dogs were tested in physiological conditions and with an i.v. infusion of atropine 20 micrograms/kg/h or secretin 0.5 CU/kg/h. The responses were also studied after antral and truncal vagotomy. In the early phase (0-20 min) of the response, before gastric emptying started, antral vagotomy reduced fluid and protein outputs, and truncal vagotomy reduced them still more. Atropine reduced only the protein response. Gastrin release reached a peak after 20-25 min. After antral and truncal vagotomy, gastrin release was reduced within 10 min after the meal. Late-phase (greater than 20 min) pancreatic secretion depended on the presence of chyme in the duodenum. The effects of atropine and antral vagotomy in the cephalogastric phase could be explained by antropancreatic reflexes stimulating fluid secretion (atropine-resistant pathway) and protein output (atropine-sensitive pathway).

[Hyperplasia of antral "G" cells. Quantitative evaluation in endoscopic biopsies]. / Hyperplasie des cellules "G" antrales. Evaluation quantitative sur biopsies endoscopiques.

The number of gastrin cells (G cells) and somatostatin cells (D cells) per surface unit, and the G/D cell ratio were estimated in biopsy specimens of the antrum from normal subjects without hypergastrinemia, and from patients with hypergastrinemia not induced by gastrinoma or supra selective vagotomy. Compared with normal subjects, antral G cell density and G/D cell ratio were significantly increased in patients with hypergastrinemia. A significant correlation was found between G cell density or G/D cell ratio and the integrated gastrin output values. A quantitative estimation appears therefore possible in biopsy specimens.

Pancreatic responses to endogenous and exogenous gastrin in the dog.

Serum gastrin and pancreatic secretion were measured in conscious Thomas fistula dogs during infusion of increasing doses of porcine gastrin, against a background of secretin. Dose-response relationships were calculated for the effects of gastrin on pancreatic secretion. Gastrin release was also measured after a test meal and after vagal stimulation with 2-deoxyglucose. Peak serum gastrin levels after these stimuli were less than the serum gastrin level associated with the minimal effective dose of gastrin. From the dose-response relationship of serum gastrin and pancreatic protein output, it was possible to calculate the protein output corresponding to the peak gastrin levels after 2-deoxyglucose or a meal. These were equivalent to 20-30% of the observed protein response to these stimuli. We conclude that gastrin plays at most a small part in the stimulation of pancreatic secretion after a meal and in response to 2-deoxyglucose. We also found that truncal vagotomy reduces pancreatic sensitivity to gastrin.

[Serum carbohydrate 19-9 Tm and bronchial cancer. Comparative study with another tumor marker, carcinoembryonic antigen]. / Carbohydrate 19-9 Tm sérique (CA 19-9 Tm) et cancer bronchique. Etude comparative avec un autre marqueur tumoral l'antigène carcino-embryonnaire.

Carbohydrate antigen 19-9 Tm (CA 19-9 Tm) level was measured in 3 groups of sera: 138 control subjects affected by bronchogenic no malignant diseases, 117 subjects with primary bronchogenic carcinoma, 43 with pulmonary metastasis of different cancers. Serum level CA 19-9 Tm was compared with serum level CEA. Control subjects bring us to state the discrimination standard between bronchogenic carcinoma and no carcinoma to 40 U/ml of CA 19-9 Tm. In primary bronchogenic carcinoma, a simultaneous increase of the two markers was noted in some subjects whereas in others only one tumor marker was increased pulmonary metastasis are considered. In these two cases, CEA increases more often in serum of subjects affected by adenocarcinomas CA 19-9 Tm and CEA are thus two different tumor associated markers.

[Role of formalin in the occurrence of sclerosing lesions of the bile ducts. Experimental approach in dogs. Apropos of 3 clinical cases]. / Le rôle du formol dans la survenue de lésions sclérosantes des voies biliaires. Approche expérimentale chez le chien. A propos de 3 observations cliniques.

The authors experimentally reproduced in dogs, sclerosing lesions of biliary tract similar to those that they noticed in clinical practice, after the use of a formalin solution for sterilization of the hydatid cysts of the liver. These lesions have been found with formalin solutions more concentrated than those used in surgical treatment of liver echinococcosis. Nevertheless, even with the use of lower concentrated solution in every case, inflammatory scars are produced in the liver and the biliary tract with persist several months after the formalin injection consequently, the authors recommend to forsake the abandonment of this product for surgical treatment of hydatid cyst.

Non-linear kinetics of ethanol elimination in man: medico-legal applications of the terminal concentration-time data analysis.

Research regarding parameters suitable for reporting on the activity of enzymatic systems responsible for ethanol metabolism is of obvious interest in medico-legal practice. Blood ethanol concentration-time curves, following oral administration of ethanol, have been developed for ethylic and non-ethylic subjects. This study has confirmed the non-linear kinetics of ethanol elimination; however, existing non-linear models appear to be inadequate for usual medico-legal practice, because of their complexity. We observed three phases during the elimination of ethanol. The first order terminal phase is characterized by its half-life. This parameter seems adequate as a basis for determining the activity of enzyme systems responsible for the metabolism of ethanol.

Evolution of plasma acetate concentration during ethanol metabolism in man.

Following oral administration of ethanol to ethylic as well as non-ethylic volunteers, the entire time course of plasma acetate concentration has been observed. The curve shows a typical evolution in three phases: (1) a quick ascending phase (2) a steady state characterized by a mean concentration (-C) (3) a first-order decrease, characterized by its half-life (t1/2) These parameters show significant variations (increase of -C, decrease of t1/2) in the ethylic subjects, in comparison with the non-ethylic ones. The variation of the area under the acetate curve according to the dose of ethanol given, is linear. The comparison of such a development with the one, typically non-linear, of the area under ethanol curve previously analyzed for the same subjects, may guess the origin of the non-linearity of ethanol kinetics.

[Approach to ethanol metabolism in man by studying the concentration-time curves of ethanol, free enzyme and plasma acetate (author's transl)]. / Approche du métabolisme de l'éthanol chez l'homme par l'étude de l'évolution de l'alcoolémie, de la concentraion d'enzyme libre et du taux d'acétate plasmatique.

The use of a pharmacokinetic model characterized by a new theoretical approach of the enzymatic reaction allows to account for ethanol concentration-time curve (after oral administration in man) and to simulate the evolution of free enzyme concentration. The interpretation of the various phases observed during these kinetics (ethanol, free enzyme) and plasma acetate kinetics (performed in the same study) constitutes an original approach to ethanol metabolism.

[Tuberculous ganglio-oesophageal fistula. A case revealed by hematemese (author's transl)]. / Fistule ganglio-oesophagienne tuberculeuse. A propos d'un cas révélé par des hématémèses.

The authors report the observation of a tuberculous ganglio-oesophageal fistula which revealed itself through several severe digestive hemorrhages. On this occasion, they recall that these fistulae are unusual and exceptionally hemorrhagic. Diagnosis can only be made by a thorough endoscopic examination. If medical treatment can be envisaged when the tuberculous nature of the lesion has been ascertained, surgery is to be prefered in case of uncertain etiology; the intervetion enables the opening of the tuberculous abscess and, at the same time, the treatment of the oesophageal perforation and the suppression of hemorrhages.

[Zollinger-Ellison syndrome with unusual symptomatology. Demonstration of the gastrinoma by endoscopic wirsungography]. / Syndrome de Zollinger-Ellison à symptomatologie inhabituelle. Mise en èvidence du gastrinome par wirsungographie endoscopique.

A 58-year-old man developed diarrhoea and duodenal ulcer related to a malignant pancreatic gastrinoma. Initial evaluations of basal acid output and serum gastrin level were not significant. Two months later they were typical of Zollinger-Ellison syndrome. The tumor was detected by endoscopic retrograde pancreatography.

Increased gastrin release in chronic calcifying pancreatitis and in chronic alcoholism.

Plasma gastrin levels were measured by radioimmunoassay before and after a test meal associated with 40 ml ethanol in 21 patients presenting with chronic calcifying pancreatitis, in 10 apparently normal subjects drinking since at least 5 years 100 g alcohol a day, in 14 subjects presenting hepatic alcoholic cirrhosis and in 18 apparently normal non alcoholic controls. Post-stimulation gastrin concentration were higher in chronic pancreatitis patients or in normal alcoholics (peak post-stimulation value: 74 +/- 41 and 74 +/- 43 pg/ml respectively) than in cirrhotics or non alcoholic controls (45 +/- 26 and 41 +/- 15 pg/ml respectively) (m +/- SD).

The effect of acetaldehyde on pancreatic and gastric secretion.

To ascertain whether any of the well-known effects of intravenous ethanol on pancreatic and gastric secretion could be due to its metabolite--acetaldehyde, a strong cytotoxic and sympathomimetic agent--acetaldehyde was given intravenously for 1 h (50, 100, and 200 mg/kg/h) in seven dogs. Acetaldehyde did not modify pancreatic secretion stimulated with secretin and caerulein, but under basal conditions 200 mg/kg/h slightly increased the volume and protein content of pancreatic juice. Acetaldehyde increased gastric secretion up to 4.03 meq/15 min in a dose-dependent manner, while serum gastrin remained unchanged. The increase of acidity persisted after propranolol and was inhibited but not abolished by ganglionic blockade. It can be concluded that physiological concentrations of acetaldehyde do not interfere with pancreatic secretion and that it is possible that the stimulatory effect of ethanol on gastric secretion is mediated at least partly through acetaldehyde.

[Physiological basis of enteral nutrition]. / Les bases physiologiques de l'alimentation entérale.

The authors discuss the various recent discoveries and fundamental data on absorption from the digestive tube and the digestive hormones. The practical applications of these data in oral feeding are underlined.

[Menetrier's disease and edematous syndrome (author's transl)]. / Syndrome oedémateux révélateur d'une maladie de Ménétrier.

The authors report a case of Menetrier's disease revealed in a 51 years woman before oedomas by systematic gastroscopy. Somes particularities of this case authorize to argue problems put by this disease: a thyroid nodule treated by L + triodothyronin; an eosinophilia; a biological study of gastric secretion, gastrin and intrinsec factor level; an hormonal, immunologic and genetic exploration; an histochimic and ultra-structural study of operative portion; its favorable evolution after total gastrectomy.