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Biomedical subjects

F Begemann

Publications and source records attributed to F Begemann.

14 recordsLinked to original sources
PubMed1979

[Reflux and reflux disease following gastric resection (author's transl)].

Intragastric concentrations of lysolecithin and bile acids were determined in 112 patients with different types of gastrectomy for peptic ulcer (Billroth I and Billroth II). These values were correlated with intragastric pH, bacterial contamination, gastric mucosal changes and Visick grading. A maximal amount of duodenogastric reflux was found in retrocolic gastrojejunostomy (Billroth II). Smaller, but still highly pathological values were observed in the antecolic gastrojejunostomy with Braun enteroanastomosis as well as in different types of gastroduodenostomy (Billroth I). 70% of the operated stomachs were bacterially contaminated. There was a good correlation between amount of reflux, bacterial contamination and pH-value. Above pH 6 no stomach was sterile, the lysolecithin-concentration increased more than proportional. Gastric mucosal changes correlated closely with the intragastric lysolecithin concentration and the bacterial contamination. There was no correlation between amount of reflux and Visick-grading, no complaints were found in some cases with extreme reflux values as vice versa. The postoperative alkaline reflux gastritis is described, the consequences including the carcinoma of the gastric stump are mentioned. The principles of ulcer surgery are analysed under these aspects.

Female↗
PubMed1979

[Duodenogastric reflux following vagotomy with and without pyloroplasty (author's transl)].

Intragastric concentrations of bile acids, lysolecithin, 14C-bile acids, pH-value, bacterial growth and gastric mucosa histology were analysed in 47 patients following selective proximal vagotomy with and without pyloroplasty. Without pyloroplasty there were normal amounts of lysolecithin, bile acids and 14C-marked bile acids. Following pyloroplasty (Heineke-Mikulicz and Jabouly) the reflux values were 2 to 4 times higher. This increase of reflux after pyloroplasty was only one fifth of that following gastric resection. Only 20% of the vagotomized stomachs showed a bacterial contamination, an atrophic gastritis could be observed in 20% of the pyloroplasty-patients. The results demonstrate, that in selective proximal vagotomy there is no, in combination with pyloroplasty only a slight reflux gastritis.

Duodenal Ulcer↗
PubMed1978

[Intragastric bile acids and lysolecithin in clinical stress ulcer risk (author's transl)].

In 10 intensive care patients with a risk of stress ulcer intragastric concentrations of lecithin, lysolecithin and bile acids were determined and compared to values in seven normal persons. All results were increased to multiple normal values. In particular lysolecithin and bile acids showed highly abnormal concentrations. These substances have a pathogenic importance for the occurrence of stress ulcers.

Bile Acids and Salts↗
PubMed1978

Influence of chenodeoxycholic acid on the kinetics of endogenous triglyceride transport in man.

Plasma lipids and triglycerides kinetics were studied in ten subjects before and after 6-8 weeks treatment with 1 g/day chenodeoxycholic acid for radiolucent gallstones. Plasma triglyceride concentration fell by 20% and phospholipid concentration rose by 5% on average; there was no change in cholesterol or free fatty acids. Body weight remained constant. Triglyceride kinetics, studied by a precursor-labelling technique, revealed a reduction both of triglyceride plasma pool and turnover rate, accompanied by a decline of more than 35% both of plasma triglyceride precursor pool and of incorporation of plasma free fatty acids into newly synthesized plasma triglycerides. Fractional turnover rates in both pools remained unaltered. The appearance-time for newly synthesized plasma triglycerides after injection of label did not change. These results indicate that chenodeoxycholic acid lowers plasma triglyceride by reducing its synthesis, thereby precluding alternative, and possibly undesired, modes of action, such as impaired secretion or increased peripheral catabolism of endogenous triglyceride. Several biochemical mechanisms may be responsible for this effect, among which stimulation of phospholipid synthesis by bile acids could play a role.

Chenodeoxycholic Acid↗
PubMed1978

The influence of beta-sitosterol on biliary cholesterol saturation and bile acid kinetics in man.

beta-Sitosterol, administered in doses of 12 g/d, resulted in a mean decrease of 11% in serum cholesterol and of 12% in biliary cholesterol saturation after 6-8 weeks. Sustained effects were found in some individuals treated for longer periods. Significant changes in bile acid kinetics could not be detected. The results lend support for further investigations of sitosterol as a possible adjunct therapy in cholelitholytic treatment.

Adult↗
PubMed1978

[Reflux-preventing gastric resection. An animal experiment study].

In 30 pigs the prevention of duodenogastric reflux following distal gastrectomy through different types of jejunal transposition or Roux-en-Y-gastroenterostomy was studied. The reflux was measured by determination of the intragastric amounts of bile acids and lysolecithin, and by the total number of glycerophosphatids. After distal gastrectomy and proximal selective vagotomy, isoperistaltic jejunal segments of different lengths were transposed between gastric remnant and duodenum. The reflux was normalized by 25-cm segments. Shorter segments led to no significant decrease of the reflux. The jejunal invagination of additional isoperistaltic valve did not have a significant effect. The same protection as from 25-cm segments was obtained by Roux-en-Y-gastrojejunostomy. The role of the duodenogastric reflux following gastrectomy for the gastric mucosa is disucssed. The necessity of the reparation of the pyloric function is shown.

Animals↗
PubMed1978

[Reflux and prevention of reflux in the resected stomach].

1. After gastrectomy or vogotomy with pyloroplasty the reflux of bile acids and lysolecithin increased. 2. The highest values of reflux were observed in the retrocolic (short loop) B-II anastomosis. The different types of B-I antrectomy and the antecolic B-II with Braun's enterostomy have each the same reflux, which is significantly lower than the retrocolic B-II. Even these types of gastrectomy have 6 - 10-fold elevated reflux values compared to the controls. After vagotomy with pyloroplasty the reflux was reduced to two or three times normal. After selective proximal vagotomy without pyloroplasty no reflux was observed. 3. After an isoperistaltic jejunal transportation, the reflux was reduced, the reduction depending on the length of the transposed segment. The same result was obtained with a ROUX-en-Y-gastro-enterostomy. 4. After hemigastrectomy and isoperistaltic transposition of 25 cm of jejunum, more reflux could be observed under experimental and clinical conditions.

Animals↗
PubMed1977

[Gastroduodenostomy and duodenogastric reflux (author's transl)].

In 36 pigs the intragastric C14 bile acid reflux and the concentration of lysolecithin is measured following different types of hemigastrectomy and gastroduodenostomy. Termino-terminal, termino-lateral and supraduodenal termino-lateral anastomosisses were as well studied as an isoperistaltic jejunal transposition of 15 cm resp. 25 cm length.-After all types of direct gastroduodenostomy the amounts of intragastral C14 bile acids and lysolecithin were significantly elevated. An additional jejunal transposition decrease the reflux in relation to the length of the transposed jejunal segment. The importance of the duodenogastric reflex of bile acids and lysolecithin for the development of alkaline reflux gastritis and carcinoma of the gastric stump is discussed. For clinical purpose a replacement of the pyloric reflux barrier by a primary jejunal transposition in case of pylorectomy has to be discussed.

Animals↗