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Biomedical subjects

F Halter

Publications and source records attributed to F Halter.

At least 127 records · Page 7Linked to original sources
PubMed1981

Therapeutic implications of duodeno-gastric reflux.

Both medical and surgical treatment of gastroduodenal reflux have many inherent limitations. Some available drugs act on gastroduodenal reflux by enhancing gastric emptying. Other agents bind bile acids intragastrically or protect gastric epithelial cells from the cytotoxic effect of duodenal juice. Bioavailability of these latter substances is not fully investigated. One has to consider that in general treatment of gastroduodenal reflux must be administered over a considerable length of time. Greater importance has, therefore, to be attached to drug safety than to any impressive short-term pharmacological effect. Such considerations are to a certain degree rate limiting factors for long-term treatment with metoclopramide, high doses of antacid, cholesytramine and prostaglandins. Due to the poor correlation between the patient's symptoms and the noxious effect of duodenal juice considerable problems have to be expected with patient's compliance. This may be one of the main reasons for the absence of convincing controlled long-term trials documenting the value of treatment of gastroduodenal reflux in gastric ulcer disease, acute or chronic gastritis and reflux oesophagitis. Better evaluated, but not without considerable hazards is the surgical treatment of gastroduodenal reflux. Biliary diversion is doubtless effective in some patients suffering from postoperative alkaline gastritis. It is, however, impossible to correlate in the individual patient postgastrectomy or postvagotomy symptoms to bile reflux and this is the main reason for the many failures of the surgical procedures.

Antacids↗
PubMed1981

Morphine-like action of enkephalin analog FK 33-824 on motility of the isolated rat colon.

Actions of the synthetic met-enkephalin analog FK 33-824 were compared to normorphine on intraluminal pressure of the isolated rat colon. Phasic and tonic contractions of isolated colonic segments in Ringer-Tyrode's solution under standard conditions were measured by intraluminal perfusion manometry. FK 33-824 or normorphine induced substantial tonic contractions of colonic muscles which lasted about 6 min. The maximum tonic contraction occurred at 10(-5) M normorphine or 10(-6) M FK 33-824. Naloxone (10(-6) M) and Mr 2266 alone or in combination inhibited competitively the tonic contraction induced by FK 33-824 with a similar potency ratio, whereas 10(-6) M norepinephrine or 10(-8) M isoproterenol inhibited it noncompetitively. Tetrodotoxin (10(-6) M) counteracted tonic contractions due to FK 33-824 or normorphine in all parts of the undissected colon but only in the proximal segment of the dissected colon and enhanced it in the middle and distal colonic segment. Neither 10(-5) M atropine sulfate nor 10(-6) M methysergide interfered with the action of FK 33-824 or normorphine. FK 33-824 produced morphine-like motor actions in the isolated rat colon evidently by stimulation of opiate receptors, suggested to be located in nervous and muscular tissue in the proximal and solely in muscular tissue in the mid and distal colonic segment. The neural pathway stimulated by FK 33-824 or normorphine is not identified. The data suggest it to be noncholinergic, nonadrenergic and nonserotoninergic.

Animals↗
PubMed1980

Healing dynamics of traumatic gastric mucosal defects in the normal and hyperacid stomach.

Previous studies in man and preliminary experiments in the pig suggested an exponential healing rate for both gastric ulcers and induced mucosal defects. This was further investigated in six pigs with histamine-induced hyperacidity and in six controls. Healing of simple surgical defects measuring approximately 1.5 cm was endoscopically monitored at 2- to 3-day intervals through a Thomas cannula. In the control animals the healing rate was not strictly exponential but conformed to an organic decay curve with maximum healing phase around the fifth day and a slow initial and late healing velocity. In the six histamine-treated animals the healing rate was significantly delayed (P < 0.02) in the first four days but thereafter resembled that of the control animals. This suggests that acid secretion may be a determinant factor, especially within the early healing phase.

Animals↗
PubMed1980

[Sonography and endoscopic retrograde cholangio-pancreatography in the diagnosis of diseases of the pancreas and biliary system (author's transl)].

The value of sonography and ERCP was studied in a retrospective series of 128 patients with pancreatic and biliary disease. Sonography and ERCP employed singly provided a correct diagnosis in 68% and 75.5% respectively; combined diagnostic accuracy rose to 85%. The inclusion of other diagnostic information produced almost identical figures for sonography and ERCP of 82% and 86% respectively. Consequently, sonography must be recommended in the first place as a non-invasive method for the diagnosis of pancreatic and biliary disease. The indications for ERCP are for the elucidation of chronic pancreatitis without pseudo-cysts and for other pancreatic abnormalities not clearly shown by sonography, and also for the demonstration of the biliary system in non-obstructive jaundice.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1979

[Cimetidine versus antacids].

The rationale of ulcer therapy with cimetidine or antacids is to block or neutralize gastric acid secretion intragastrically. 5 tablets of cimetidine can inhibit gastric acid secretion in duodenal ulcer patients by more than 50% over a 24-hour period. Approximately 250 ml per day of a highly active antacid is necessary to achieve a similar effect. The effect of cimetidine on night secretion is superior. In acute ulcer attack cimetidine brings about healing of the ulcer in duodenal ulcer disease in about 80% of all patients in about 4-6 weeks, and a maintenance dose of 200 mg in the evening may prevent a recurrence within a year in about 50% of all patients. According to American studies, antacid therapy in the above-mentioned dosage may achieve a similar healing rate in duodenal ulcer patients in acute attack. However, it is unknown whether high antacid therapy prevents ulcer recurrences. If acceptability of the treatment by the patient, side effects and costs are taken into account, cimetidine appears to be superior to high doses of antacid. However, it must be considered that in many European countries, including Switzerland, the spontaneous healing rate is up to 60% in placebo studies. It is thus legitimate to continue treating uncomplicated ulcers with the small antacid doses customary in Europe.

Antacids↗
PubMed1979

A double-blind trial of loperamide in the treatment of chronic diarrhoea.

A new antidiarrhoeal compound, loperamide (Imodium; (Janssen) Ethnor) has been evaluated in the treatment of patients with chronic nonspecific diarrhoea. In a double-blind trial its effect was compared with that of a placebo. The results of this trial indicate that loperamide is an effective antidiarrhoeal compound.

Adolescent↗
PubMed1979

Effects of prolonged administration of metiamide on serum gastrin, gastrin content of the antrum and gastric corpus, and G-cell population in the rat.

The effect of prolonged metiamide administration on serum gastrin, gastrin content of the antrum and gastric corpus, and G-cell population was studied in the rat. A single subcutaneous injection of metiamide (200 mg/kg) at the onset of 16 days of continous treatment with three daily injections was followed by a fivefold increase in serum gastrin level at 4 hr in fasted and at 4 and 6 hr in fed rats. After 16 days of metiamide, the fed rats showed a peak in serum gastrin level of the same magnitude as on day 1, but only at 4 hr. Two hours later, the levels decreased rapidly to basal values. In the fasted animals, the response to metiamide was reduced to a threefold increase at 2 hr. There was no difference in gastrin content of the antrum and gastric corpus nor in volume density of the G-cells after the prolonged treatment compared with the controls. It is concluded that in spite of rises in serum gastrin, prolonged metiamide medication has no effect on the gastrin content of the antrum and gastric corpus nor on the G-cell population in the rat. Furthermore, after prolonged treatment, metiamide-induced gastrin release is diminished.

Animals↗
PubMed1979

[Effect of duodenal acidification on plasma secretin and pancreatic polypeptide in man (author's transl)].

Plasma secretin and pancreatic polypeptide has been measured in 10 normal volunteers before and after intraduodenal acidification. Secretin rose rapidly from 1,4 +/- 0,44 to 11,2 +/- 1,24 pmol/l (+/- SEM). PP also rose significantly from 39,0 +/- 3,0 to 52.3 +/- 5,8 pmol (paired p less than 0.01) but much slower and to a lesser extent than seen after a meal. This supports the conclusion that acid plays no important role in control of postprandial PP release.

Adult↗
PubMed1978

[Indications for and dangers of methods for gastroenterological endoscopy].

The value of modern fiberoptic endoscopy is discussed by comparing negative and positive aspects of both radiology and endoscopy. A detailed analysis is provided of the complications observed in 16,477 invasive gastrointestinal investigations performed over the last 11 1/2 years in our unit. The morbidity was 0.1% in 5886 large bowel examinations and 0.2% in esophago-gastroduodenoscopy and in all 2871 investigations involving invasive liver-pancreas diagnostics. The overall mortality was 0.06%. It is emphasized that in invasive gastrointestinal examinations elderly and debilitated patients are at risk, whereas the danger is minimal for patients in reasonable health.

Aged↗
PubMed1978

A comparison between intragastric titration and aspiration technique under basal conditions and after food or pentagastrin stimulation.

A total of 16 healthy subjects had gastric secretory studies where acid was either measured by the conventional aspiration technique (AT) or by intragastric titration at a pH of 5.0 (IT). In a first study food- and pentagastrin-stimulated PAO levels, both measured by IT, were within similar ranges. However, as compared to the respective AT data of the same subjects, the mean IT results were 35% higher, although both values were well correlated. In a second study a similar difference was observed between IT and AT data throughout the whole range of the pentagastrin dose-response curve. Both curves followed Michaelis-Menten kinetics and had similar Km values, while Vmax values were significantly higher at IT. This constellation excludes an increase of the gastrin sensitivity of the parietal cells as a cause for the higher IT data. It is, however, in keeping with the hypothesis that the distension stimulus present at IT potentiates the pentagastrin-stimulated acid secretion. It is likely that methodological problems such as overtitration of acid at IT and transpyloric loss of acid at AT additively contribute to the relatively large difference between AT and IT values. It is therefore not possible to fully interchange AT and IT data, despite their good correlation.

Adult↗