Manometric and scintigraphic studies of the relation between motility disturbances in the Roux limb and the Roux-en-Y syndrome.

After a Roux-en-Y gastrojejunostomy, patients frequently complain of abdominal pain, fullness, nausea, and vomiting. This so-called Roux-en-Y syndrome is caused by slow gastric emptying, Roux-limb stasis, or both. The pathogenesis of these transit disorders is unknown.

Anaerobes and their fermentation products in faeces of patients with familial adenomatous polyposis before and after subtotal colectomy and ileorectal anastomosis.

In view of the importance of short-chain fatty acids (SCFA) for the colonic epithelial function and their possible relation with the reported spontaneous regression of rectal polyps after subtotal colectomy with ileorectal anastomosis, we compared the SCFA concentrations in faeces of five familial adenomatous polyposis (FAP) patients before, and in 10 FAP patients after operation to each other and to those of 10 healthy controls. Anaerobe cultural counts and concentrations of organic acids were also investigated in the same faecal samples from FAP patients and controls. The preoperative cultural counts were not significantly different from those of the controls.

Is chemotherapy associated with development of Barrett's esophagus?

Columnar-lined or Barrett's esophagus is a premalignant condition. It is almost unvariably due to chronic gastroesophageal reflux. Since there are some reports that Barrett's esophagus can be induced by chemotherapy, we investigated 20 male patients, treated with chemotherapy for testicular cancer, and 18 female patients, treated with high-dose chemotherapy for breast cancer.

Prevalence and characterization of neutrophil cytoplasmic antibodies in autoimmune liver diseases.

To evaluate the diagnostic significance of neutrophil cytoplasmic antibodies in chronic liver diseases, we assessed the prevalence of neutrophil cytoplasmic antibodies in autoimmune liver diseases, in particular in primary sclerosing cholangitis, autoimmune chronic active hepatitis and primary biliary cirrhosis, and we also determined the specificity of perinuclear-pattern neutrophil cytoplasmic antibodies for these autoimmune liver diseases by testing sera from patients with nonautoimmune chronic liver diseases. Neutrophil cytoplasmic antibodies were detected in 79% of sera from patients with primary sclerosing cholangitis (n = 24), in 88% of sera from patients with autoimmune chronic active hepatitis (n = 24) and in 28% of sera from patients with primary biliary cirrhosis (n = 25). The presence of neutrophil cytoplasmic antibodies in these diseases correlated significantly (p < 0.

Epithelial cell proliferation in the sigmoid colon of patients with adenomatous polyps increases during oral calcium supplementation.

To study the effect of oral supplemental calcium on colonic epithelial proliferation, 17 adenomatous polyp patients received 1.5 g Ca2+ as calcium carbonate daily during 12 weeks, while on a calcium constant diet, based on the patients' habitual diet. Seven subsequently continued calcium supplementation for 9 months without dietary restrictions.

Mechanism of the protective effect of supplemental dietary calcium on cytolytic activity of fecal water.

Dietary calcium supplementation inhibits hyperproliferation of rectal epithelium, possibly by precipitating luminal surfactants and thus preventing their cell-damaging effects. Therefore, we studied the effects of supplemental dietary calcium (35.5 mmol/day) on composition and cytolytic activity of fecal water and on the release of the epithelial marker alkaline phosphatase in 12 healthy volunteers.

Effects of oral calcium supplementation on intestinal bile acids and cytolytic activity of fecal water in patients with adenomatous polyps of the colon.

Calcium has been proposed to prevent colon cancer in subjects at risk for this tumour. This effect is supposed to be due at least in part to binding the bile acids to calcium, making them insoluble and harmless. To evaluate the effects of oral calcium supplementation on intestinal bile acids, 19 patients with adenomatous colonic polyps were supplemented with 35.

Transit disorders of the gastric remnant and Roux limb after Roux-en-Y gastrojejunostomy: relation to symptomatology and vagotomy.

Patients after Roux-en-Y gastrojejunostomy frequently complain of upper abdominal pain, fullness, nausea and vomiting. This study was performed to clarify the relationship of this Roux-en-Y syndrome to transit disorders in the gastric remnant and Roux limb, and to vagal status. Using a questionnaire, 35 of 66 patients operated on between 1976 and 1987 were judged to suffer from the Roux syndrome.

The reduced canine pancreas to study the effects of intra-operative radiotherapy.

A canine model is described to study the tolerance of the pancreas to intra-operative radiotherapy (IORT). The canine pancreas is a horseshoe-shaped organ. To create a homogeneous delivery of IORT to the whole pancreas surgical manipulation is necessary which may induce pancreatitis.

Anti-neutrophil cytoplasmic antibodies (ANCA) in autoimmune liver disease.

ANCA were detected in 67% of sera from patients with primary sclerosing cholangitis (n = 15), in 83% of sera from patients with autoimmune chronic active hepatitis (n = 18) and in 35% of sera from patients with primary biliary cirrhosis (n = 20). ANCA were not detected in non-autoimmune chronic liver diseases. Characterization studies of the antigens involved showed that ANCA in autoimmune liver disease are not directed against myeloperoxidase (mpo), proteinase 3 (pr3) or elastase (hle), but the ANCA in autoimmune liver disease show reactivity with lactoferrin, a 67/66 kD protein combination or a 63/54 kD protein combination on Western Blots.

Barrett's oesophagus and carcinoma. Recent insights into its development and possible prevention.

Barrett's oesophagus or columnar epithelium-lined oesophagus is a condition due to chronic gastro-oesophageal reflux. In addition to acid-peptic reflux, reflux of duodenal contents may have a role in its aetiology. The clinical importance of Barrett's oesophagus is the increased risk for development of oesophageal adenocarcinoma.

Recent developments in diagnosis and treatment of metastatic carcinoid tumours.

In carcinoid patients a tumour of enterochromaffin cell origin is present, which dependent on the site of origin can result in increased serotonin production. Metastasized carcinoids are often diagnosed by measuring 5-hydroxyindoleacetic acid excretion in the urine. This excretion, however, can be influenced by food intake.

Changes in rectal epithelial cell proliferation and intestinal bile acids after subtotal colectomy in familial adenomatous polyposis.

Subtotal colectomy and ileorectal anastomosis in familial adenomatous polyposis patients can induce temporary regression of adenomas in the rectum. The mechanism for this phenomenon is unclear. We evaluated the effect of colectomy on rectal mucosal proliferation, in relation to changes in bile acid metabolism.

Regulation of gastric acid secretion by gastrin in duodenal ulcer patients and healthy subjects.

To examine the role of gastrin as a major mediator of meal-stimulated acid secretion at low and high intragastric pH, gastric acid secretory responses after exogenous and endogenous stimulation were studied in relation to circulating plasma gastrin levels in 19 healthy control subjects and in 18 patients with inactive duodenal ulcer disease. Gastrin was given intravenously in stepwise fourfold-increasing doses from 3.1 to 800 pmol.

Cisapride in treatment of Roux-en-Y syndrome.

Unlabelled: After Roux-en-Y gastrojejunostomy patients frequently complain of upper abdominal pain, fullness, nausea, and vomiting. This Roux-en-Y syndrome is caused by slow gastric emptying, Roux-limb stasis, or both. Treatment of this syndrome is cumbersome.

Calcium phosphate, bile acids and colorectal cancer.

The biochemical and nutritional studies discussed here are consistent with the model presented in Figure 1. As shown in vitro, bile acids are precipitated by insoluble calcium phosphate. This calcium phosphate dependent precipitation drastically inhibits their cytotoxicity.

Evaluation of a new catheter for esophageal pH monitoring.

A new catheter, provided with an Ion Sensitive Field Effect Transistor as a pH sensor and incorporating a reference electrode, was evaluated for esophageal pH recording. The pH-sensitivity was 54 mV/pH in vitro, with a linear response between pH 2 and pH 9. Clinical semi-ambulatory 24-hour esophageal pH recordings were carried out in 6 adults and 15 infants.

Acute effects of continuous nasogastric tube feeding on gastric function: comparison of a polymeric and a nonpolymeric formula.

The acute effects of continuous intragastric administration of 1500 ml (4200 kJ/liter) of a polymeric and of a nonpolymeric formula on gastric function were studied in 15 healthy subjects. During 450 min 1500 ml, containing 6300 kJ (1500 kcal), was given through a nasogastric tube. At regular intervals the volume, the pH, the titratable acidity, and the pepsin activity of the gastric contents and the plasma gastrin concentration were determined.

Calcium and the prevention of colon cancer.

Diet is a major determinant of colon cancer risk. Calcium may protect against colon cancer, presumably by binding cytotoxic bile acids and fatty acids. Numerous studies support this proposition.

Effects of cisapride on the esophageal motor function of patients with progressive systemic sclerosis or mixed connective tissue disease.

In a double-blind crossover study lower esophageal sphincter pressure and distal esophageal motility were studied in 10 patients with progressive systemic sclerosis or mixed connective tissue disease, following a single intravenous dose of cisapride or placebo. The measurements were carried out under basal conditions and 30 min after intravenous administration of 10 mg cisapride or placebo. No effects on lower esophageal sphincter pressure or distal esophageal motility were observed.

Effects of supplemental dietary calcium on the intestinal association of calcium, phosphate, and bile acids.

It has been suggested that supplemental dietary calcium decreases hyperproliferation of colonic epithelial cells because calcium precipitates and thus inactivates luminal bile acids. Therefore, 12 healthy men were studied before and after dietary calcium supplementation (35.5 mmol/day) to quantify intestinal associations of calcium, phosphate, and bile acids.

Noncardiac chest pain: is the esophagus really a frequent source?

The occurrence of esophagus-related noncardiac chest pain was investigated in 22 unselected consecutive patients referred by local cardiologists. The investigations included endoscopy, standard manometry, esophageal scintigraphy, a double-blind placebo-controlled edrophonium provocation test on two occasions (during manometry and scintigraphy), an acid perfusion test, and 24-h ambulatory esophageal pH-monitoring. Nine patients had reflux symptoms; none had dysphagia.