Biomedical subjects
Publications and source records attributed to D Sailer.
The increase in serum uric acid induced by cytostatic drugs may be treated by a combined low-dose uricostatic and uricosuric regimen. The results obtained in an intraindividual cross-over study demonstrate the significant influence on serum uric acid and its renal excretion.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In a randomised clinical study 20 diabetics were given a des-phe-mixed-insulin. The quality of diabetes control was investigated. The average age of the patients was 53 years; the duration of the diabetes was 8.7 years in average. As criterion of diabetes control were accepted: a daily urinary excretion up to 10 g and a peak value of blood-sugar in the daily profile of 9.99 mmol/l (180 mg/dl). In 9 of the 20 patients the diabetes could be controlled easily by using des-phe-mixed-insulin. In the remaining 11 patients no sufficient control was achieved. These 11 patients were treated successfully within five days using a highly purified insulin from the pig (Mixtard). Compared to the des-phe-mixed-insulin the dose could be reduced by 26% in average. Two patients developed an allergy against the des-phe-mixed-insulin; one locally, one generalized.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The hypoglycemic effect of a glycoside hydrolase inhibitor (BAY g 5421) was tested in 10 non-insulin dependent, overweight diabetics by means of continuous in vivo glucograms. There was a highly significant reduction of serum glucose with a dosage of 3 x 100 mg glycoside hydrolase inhibitor, after dosage division to 6 x 50 mg there was an additional reduction of blood glucose. This difference, however, could not be determined statistically. Insulin, glucagon and lactate as well as the triglyceride concentration remained unchanged. There were no significant side-effects. Two of the 10 patients complained of meteorism, after specific questioning three more patients offered similar complaints. Discontinuation of the preparation was not necessary.
A calorie sufficient intravenous nutrition for the severely ill is possible today with practically no limitations. Carbohydrates and fats are available as energy-donators. The maximum administration rate for glucose is 0.5 g/kg/h, however, in the postoperative phase it is only 0.25 g/kg/h. The dosage limit for fructose and sorbitol is likewise 0.25 g/kg/h and only 0.125 g/kg/h for xylitol. By taking advantage of the various metabolic pathways for the individual carbohydrates, a mixed-carbohydrate solution has been developed which is utilizable in a dosage of 0.5 g/kg/h. The fat emulsions which are commercially available today consist of soy bean oil with egg lecithin or phosphatides as emulsifiers. They are well tolerated and offer several advantages in contrast to high-percentage carbohydrate solutions. In newer developments, MCT fats are added as quickly utilizable substrates. Only L-amino acids should be used today in parenteral nutrition because of their specific utilization by the organism. In addition to the administration rate (0.1 g/kg/h), the relationship between essential and non-essential amino acids is decisive for utilization, whereby the so-called E/T ratio should be as high as possible. Improved substrate utilization can be achieved through the simultaneous administration of carbohydrates, protein and fat as well as minerals and vitamins, whereby the total daily requirement can be administered within 12 hours without metabolic dysfunction.
Lactate, pyruvate, creatinine, urea, blood sugar and the serum concentration of phenformin or buformin were analyzed in the venous blood of a total of 90 diabetics who received biguanides regularly for at least one month. The creatinine clearance as well as the lactate-pyruvate quotient were computed. Age, body weight and size as well as duration of medication were recorded. Twenty-three diabetics who did not receive biguanides were used for control. Almost all patients revealed a mostly minor hyperlactatemia which was also observed in the control group. There was no significant difference between the two groups. There was no relationship between renal function, the serum lactate level and the biguanide concentration.
A metabolic monitoring system is described that allows the simultaneous and automatic in vivo analysis of the metabolic parameters glucose, pH, and pCO2 as well as the computer-controlled automation of the possible necessary infusion therapy. This bedside system has proved to be useful in treating acidotically and non-acidotically decompensated diabetes mellitus. Our experience with this system is as follows: 1. quick correction of the acidosis without danger of alkalosis, 2. shorter period of treatment, 3. considerably reduced insulin requirement, 4. no danger of hypoglycemia, and 5. minimum net blood withdrawal (1.2 ml/h). The efficiency of this system is demonstrated by examples.
Explore the source record for details and available documents.
A mult-channel system for continuous bedside monitoring of glucose, pH pCO2 and automatic computer-controlled infusion of insulin, glucose, potassium, and bicarbonate solutions is described. Regulatory algorithms are presented for correction of metabolic acidosis and hyperglycemia with and without acidosis.
After a continuous intravenous 3-hour infusion of 500 ml fat emulsion containing MCT, composed of 25 g soybean oil and 25 g MCT oils, there was an infusion-induced increase of all fatty acids administered. The medium-chain fatty acids (C8-C12) revealed ideal steady-state conditions and were quickly eliminated after the infusion. The reaction of linoleic acid (C18:2) was not as favorable. Linoleic acid increased steadily during the infusion, and its elimination rate from the serum was delayed.
It is estimated that in the Western hemisphere approximately 50% of all carcinoses in females and approximately 30% of all carcinoses in males are influenced by dietary factors. The most frequent carcinogenic dietary compounds are the polycyclic aromatic hydrocarbons, the nitrosamine combinations and the mycotoxins. Exact data on the carcinogenic risk of these dietary compounds is, however, not yet available for humans. Epidemiological investigations also support the assumed dietary carcinogenesis. It is known that the contracting rate for carcinoma of the stomach is considerably higher in Japan than in Europe or in the USA and that the morbidity rate for carcinoma of the colon is considerably lower in Third World countries. The positive incidence between dietary fat uptake and carcinoma of the breast seems to be well established.
Explore the source record for details and available documents.
Dietary therapy after gastrectomy demands a differentiated approach. In the immediate postoperative phase parenteral nutrition is indicated. If no complications occur, the transition to oral nutrition can soon be made, the basic principle of which is adherence to 6-8 small meals. Since, in our experience, after gastric resections numerous disorders can occur, a carefully controlled diet with the aid of nutrional anamnesis is to be recommended. At the same time substitution of vitamin B12, iron, calcium and pancreatic enzymes is absolutely essential.
Explore the source record for details and available documents.