ABSTRACT
BACKGROUND: Adenomatous colonic polyps are accepted as premalignant lesions. There is controversy regarding the significance of the hyperplastic polyp. The aim of this study was to determine the incidence of further polyps in patients with only hyperplastic polyps on a first colonoscopy in comparison with patients without polyps and with adenomatous polyps. METHODS: Ninety patients had only hyperplastic polyps (group I). These patients were paired according to age and sex with subjects having no polyps (group II) and with patients having adenomas (group III). RESULTS: Fifty-six patients in group I had at least one follow-up examination. New polyps were found in 46.4% in group I versus 15.5% in group II (p < 0.001) and 50% in group III (NS). In group I, 30.7% of new polyps were hyperplastic and 69.3% were adenomas. In fact, 32.2% of group I patients developed further adenomas (mean 1.5 +/- 0.8 adenomas). These adenomas occurred 1 to 4 years after the first polypectomy (mean 2.4 +/- 0.8 years). Most of these adenomas were small and tubular, but 16.6% were villous or had severe dysplasia. CONCLUSION: Patients with hyperplastic polyps were 2.4 times more likely to have further adenomas than were those without polyps.
Subject(s)
Adenomatous Polyps/epidemiology , Colonic Polyps/epidemiology , Adenoma, Villous/epidemiology , Case-Control Studies , Colon/pathology , Colonic Polyps/pathology , Colonoscopy , Female , Follow-Up Studies , Humans , Hyperplasia , Incidence , Logistic Models , Male , Middle Aged , Neoplasms, Second Primary/epidemiology , Prospective Studies , Retrospective Studies , Risk Factors , Time FactorsABSTRACT
AIM: To evaluate the effects of various doses of lintopride, a new 5HT-4 antagonist with moderate 5HT-3 antagonist properties, on oesophageal body and lower oesophageal sphincter (LOS) motility in humans. METHODS: Eight healthy male volunteers, mean age 22 (19-28) years, without any history of digestive disease or chest pain, were randomized to three doses of lintopride (0.1, 0.3 and 0.5 mg/kg i.v.) and a placebo at 1-week intervals in a double-blind, crossover study. Oesophageal motility was recorded continuously for 4 h after each dose, using perfused catheters inserted at the level of the LOS and in the body of the oesophagus, at 5, 10 and 15 cm from the LOS. Peristalsis was studied during 10 wet swallows, at 30-min intervals (T0-T240 min). RESULTS: The LOS basal pressure (23.3 +/- 2.0 cmH2O; mean +/- s.d.) remained stable after dosing with placebo to T240. After lintopride, LOS basal pressure increased significantly vs. placebo (AUC comparison: 0.1 mg/kg, P = 0.036; 0.3 mg/kg, P = 0.027; 0.5 mg/kg, P = 0.052). In contrast, the duration and extent of LOS relaxation after swallowing was not affected by any of the three doses of lintopride. The amplitude of peristaltic waves in the oesophagus increased significantly at T30 after lintopride 0.3 mg/kg (34.5 cmH2O, P = 0.020) and 0.5 mg/kg (32.5 cmH2O, P = 0.027), at T60 after 0.3 mg/kg (48.8 cmH2O, P = 0.0009) and 0.5 mg/kg (29.1 cmH2O, P = 0.029) and at T90 after 0.3 mg/kg (34.5 cmH2O, P = 0.0018). CONCLUSIONS: Lintopride significantly increased the LOS basal tone without affecting LOS physiological relaxation after swallowing. Peristaltic waves were also enhanced by lintopride.
Subject(s)
Esophagus/drug effects , Gastrointestinal Motility/drug effects , Imidazoles/pharmacology , Receptors, Serotonin/drug effects , Adult , Esophagogastric Junction/drug effects , Esophagus/physiology , Humans , Imidazoles/administration & dosage , Male , Muscle Contraction/drug effects , Muscle, Smooth/drug effects , Peristalsis/drug effects , Receptors, Serotonin, 5-HT4 , Reference ValuesSubject(s)
Lactoferrin/analysis , Lactoglobulins/analysis , Pancreatic Neoplasms/diagnosis , Humans , Male , Middle AgedABSTRACT
In a prospective study we have measured the lactoferrin level of duodenal juice under secretin plus caerulein pancreatic stimulation in 78 subjects. Subjects was divided in 4 groups as follows: 27 controls, 11 pancreatic disease without chronic pancreatitis (CP), 17 CP and 23 suspicions of CP. Lactoferrin was assayed by radial immunodiffusion and the level was referred to lipase activity. The test was considered as positive when lactoferrin (microgram/ml) X 100/lipase (U/ml) greater than 0.1. No one control subject had a positive test, 2 pancreatic cancers out of 4, 1 acute pancreatitis out of 7, 12 CP out of 17 had a positive test. The sensitivity (0.71) and the specificity (0.92) of the test do not allow us to propose this test as unequivocal in the diagnosis of CP.
Subject(s)
Duodenum/metabolism , Lactoferrin/analysis , Lactoglobulins/analysis , Pancreatitis/metabolism , Body Fluids/metabolism , Chronic Disease , Humans , Pancreatitis/diagnosisABSTRACT
From 16 volunteers with chronic pancreatitis and 36 healthy subjects duodenal biopsies were taken 15--20 cm beyond the papilla of Vater. Several morphometric parameters were calculated. The main results show: a significant decrease of villous area and height but not of the number of intestinal villi; a significant increase of Paneth cells; and a slight decrease in the number of glandular mitoses. This study suggests in man, a possible relationship between exocrine pancreatic secretion and the intestinal mucosa and a trophic action of pancreatic juice on the proliferation and the differentiation of the intestinal mucosa.
