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Biomedical subjects

F Halter

Publications and source records attributed to F Halter.

At least 109 records · Page 6Linked to original sources
PubMed1976

The development of a reliable and sensitive bioassay for gastrin in body fluids.

The sensitivity and reliability of the Ghosh and Schild rat stomach preparation was improved by implantation of bulky intragastric cannulae, recirculation of the perfusate and measurement of conductivity instead of pH. With these procedures, the threshold values for gastrin I were in the range of 1-2 ng. In attempts to increase the sensitivity further it was shown that neither vagotomy nor antrectomy influenced the sensitivity of the method. The threshold values were not lowered by attempts to reduce gastrin metabolism through nephroligature or small bowel resection. Although rats fitted with portacaval shunts did raise the threshold, the limited increase in sensitivity was also achieved by selecting the rats that gave an initially high response to a test dose of gastrin thus avoiding the complicated shunt operation. The assay procedure enabled statistically valid measurements of gastrin in plasma and from tumour extracts from patients suffering from the Zollinger-Ellison Syndrome to be assayed using a 2 + 2 block design.

Analysis of Variance↗
PubMed1976

Evaluation of specific value of endoscopic biopsies and brush cytology for malignancies of the oesophagus and stomach.

The value of multiple biopsies and brush cytology at oesophago-gastroscopy was assessed in relation to macroscopy and localization on 100 verified tumours in a prospective study. The cumulative accuracy achieved was 96%. This was significantly better (P less than 0-01) than that of biopsy (83%) and of cytology (85%). While the reliability of both procedures was not significantly different in malignancies of the oesophagus, the gastric body, and the antrum, cytoloty was significantly more accurate in cancers of the cardia (90% and 55% respectively, P less than 0-05). Cytology was also more reliable in stenosing tumours (92%/72%,P less than 0-05). In polypoid malignancies a positive but not significant trend was found in favour of multiple biopsies (94%/64%). One of the two early cancers was only diagnosed by cytology. The results confirm the high diagnostic accuracy of multiple endoscopic biopsies combined with brush cytology and demonstrate the value of cytology in stenosing tumours, especially in those of the cardia.

Adult↗
PubMed1976

Lower esophageal sphincter in reflux esophagitis.

Lower esophageal sphincter pressure (LESP) was studied by intraluminal perfusion-manometry in the resting state and after graded intravenous doses of pentagastrin in 12 healthy subjects and 27 patients with reflux esophagitis. These patients were classified as having ulcerative (11) or non-ulcerative esophagitis (16) by histological examination and endoscopic appearance of the inflamed mucosa. The length of the LES was similar in patients and controls. A correlation was found between the magnitude of mean basal end-expiratory (mbe) LESP reduction and the grade of esophageal mucosa inflammation. The most reduced mbe LESP value was shown in patients with ulcerative esophagitis. It was significantly different from that of patients with non-ulcerative esophagitis (t = 3.37, p less than 0.01). Both values were significantly reduced from that of the controls (t larger than or equal to 0.0125). The responsiveness of the LES to intravenous pentagastrin was quantitatively reduced throughout the whole range of the dose-response curve in patients with ulcerative esophagitis, whereas patients with non-ulcerative esophagitis only differed in the maximum mbe pressure value from the controls. Four patients showed a paradoxical pressure decrease to intravenous pentagastrin, resulting in a LESP reduction to 8% of the mbe LESP. Intravenous secretin or CCK led to a similar reaction of the LES in these patients.

Adult↗
PubMed1975

[Clinical problems of amebiasis].

Dagnostic and therapeutic problems of amebiaiss, a disease rarely observed in this country, are discussed in the light of four own cases representing the various courses of the disease. These observations prompt the following conclusions: 1. Amebiasis should be considered in cases of unclear acute or chronic intestinal disease, even if the patient has never visited endemic regions. 2. Non-tropical forms of amebiasis may follow a severe course with complications such as liver abscess or ameboma. 3. The advice of a specialized laboratory is necessary for stool examinations on amebae. 4. Stool examinations for amebiasis should be combined with serological tests. The immunofluorescense test is of special value. False negative results are however possible, especially in cases without tissue inflitration where the infection is limited to the intestinal lumen. 5. Metronidazol (Flagyl) greatly simplifies the treatment of amebiasis as it is both efffective and better tolerated than most other antiamebic agents.

Adult↗
PubMed1975

[Pre and postoperative secretion studies in selective proximal vagotomy. Report on 50 patients].

In 50 patients with peptic ulcer (48 duodenal ulcers and 2 pyloric channel ulcers) proximal gastric vagotomy was performed. The diagnosis was confirmed by radiology and endoscopy in all cases. Pentagastrin-stimulated maximal acid output (MAO) was measured preoperatively. At 6-12 months after the operation a pentagastrin test (6 mug/kg) and an insulin test (12 units regular insulin intravenously) were carried out. The results of the insulin tests were assessed by 5 criteria. In patients with 3 or more positive criteria the vagotomy was considered incomplete. 30 patients had "complete" and 20 "incomplete" vagotomy. MAO was reduced by 56%. The mean reduction of MAO was 63% in cases of "complete" vagotomy and 46.5% in "incomplete" vagotomy. The purpose and indication of postoperative studies of gastric secretion are discussed.

Duodenal Ulcer↗
PubMed1975

[Indications for and effectiveness of retrograde cholangiopancreatography].

The practical value of endoscopic retrograde cholangiopancreatography (ERCP) has been evaluated on the basis of experience in 159 own examinations. The cannulation rate as an important index of the success rate rose with experience, and was 85 percent in the last 110 cases. Diagnostic information was however obtained only in 65 percent, as it was not always possible to cannulate the appropriate ductule system and differentiation between chronic inflammatory and neoplastic pancreatic disease was often difficult. The greatest reliability was found in bilary duct disease, though the difference as compared with pancreatic disease was not significant. With strict limitation of the indication and a few important precautions (avoiding parenchymography of the pancreas and prompt surgical drainage of an obstructed biliary duct or pancreatic pseudocysts) no severe complications were observed throughout this series. The morbidity was thus limited to 4 cases of pancreatitis of moderate severity. In spite of the limitations of ERCP in differentiating malignant from chronic inflammatory pancreatic disease, the method was valuable for establishing the indication for, and planning, surgery. Furthermore, the diagnostic reliability was improved by combining ERCP with selective pancreatic angiography.

Cholangiography↗
PubMed1975

[Selective pancreatic angiography and retrograde pancreatic cholangiography as a combined examination].

The diagnostic value of selective pancreatic angiography and retrograde pancreatic cholangiography used in combination was studied in 24 patients with chronic pancreatitis or pancreatico-duodenal carcinomas. This was done as a prospective study. The accuracy of the individual methods is 75% and 79% respectively; used in combination, a correct diagnosis is obtained in 91% of cases. The advantage of combining the techniques depends on the fact that they supplement each other.

Adenoma, Bile Duct↗
PubMed1975

Secretin snuff: evaluation of the action on pentagastrin-stimulated gastric acid secretion and on pancreatic bicarbonate production.

In an informative qualitative study 75 U (near the range of 1 U/kg) secretin given as a snuff resulted in a weak but significant stimulation of pancreatic bicarbonate output in 8 volunteers studied. The result further indicated that this dose would slightly inhibit pentagastrin-stimulated gastric acid secretion. This was confirmed in a quantitative study at the dose of 150 U (similar to 2 U/kg), and the mean amount of inhibition of MAO was 30% in the 10 subjects studied. A supramaximal dose of 1 mg (approximatively 54 U/kg) of synthetic secretin given to one volunteer resulted in a transient block of near maximally pentagastrin-stimulated gastric acid secretion. The amount of acid inhibition as compared to a control experiment was 45% in the first and 52% in the two post-secretin hours. These results indicate that secretin given as a snuff at dose levels that would induce maximal pancreatic secretion when given as an i.v. injection results only in a weak inhibition of stimulated gastric acid secretion and evokes only a little stimulation of pancreatic bicarbonate secretion. Supramaximal secretin snuff doses have, however, a potent effect on both gastric and pancreatic secretion that is of similar order to that achieved by intravenous secretin. Owing to the obviously incomplete absorption of secretin through the nasal mucosa, secretin snuff is unlikely to solve the therapeutic problem of duodenal ulcer disease. If, however, an active fragment of the peptide could be synthetized at a reasonable price, the greater convenience of pernasal application might compensate for the partial loss of action.

Adult↗