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Biomedical subjects

G Jost

Publications and source records attributed to G Jost.

At least 19 recordsLinked to original sources
PubMed1996

[Colonic preparation with sodium phosphate. Prospective, randomized, placebo-controlled double blind study with various antiemetics].

UNLABELLED: The well established bowel cleansing method using a polyethylene glycol-based solution (Fordtran) is limited by the necessity of large volume intake, which proves difficult for many patients. Therefore, a new method using small volumes (2 x 90 ml) of oral sodium phosphate is employed more and more frequently. Its only disadvantage is the occurrence of considerable nausea or occasional vomiting in about 25% of patients. To ascertain whether nausea could be reduced, 426 patients were given an antiemetic (ondansetron, metoclopramide, cisapride) or placebo on a randomized, double-blind basis, one hour before sodium phosphate intake. RESULTS: sodium phosphate was well tolerated in 69.2% of the patients on placebo, 73.6% on cisapride, 76.5% on metoclopramide and 80.4% on ondansetron. Taking all four groups together, male patients exhibited much better tolerance (86.1%) than females (66.1%). Severe nausea and/or emesis was noted in 22.4% of patients on placebo, 21.7% on cisapride, 17% on metoclopramide and 14% on ondansetron. In over 90% of patients colon cleansing was rated as good to very good. This was largely independent of the severity of nausea. 129 patients who had undergone former polyethylene glycol-based lavage judged sodium phosphate to be more tolerable and easier to complete. Considering known contraindications (symptomatic congestive heart failure and/or renal failure), no serious adverse event was noted in any of the 426 patients investigated. In accordance with several recent studies, we consider sodium phosphate solution at present the procedure of choice for colon cleansing. Compared to Fordtran, patient acceptance is far better and cleansing quality superior. Routine antiemetic comedication for reducing possible nausea/vomiting is not worthwhile. On the other hand, this study confirms our former impression of enhanced colon cleansing after administration of an additional mild laxative before sodium phosphate, without interfering with patient acceptance.

Administration, Oral↗
PubMed1996

Ciprofloxacin pharmacokinetics in burn patients.

Many drugs exhibit altered pharmacokinetic parameters in burn patients. We prospectively evaluated the pharmacokinetics of ciprofloxacin in eight burn patients with active infections. Each patient received a 400-mg dose of ciprofloxacin intravenously (i.v.) every 8 h, with each dose infused over 1 h by using a rate control device. Blood samples for analysis of plasma ciprofloxacin concentrations, determined by high-performance liquid chromatography, were obtained immediately predose, at the end of the infusion, and 1, 2, 3, 4, 5, 6, and 7 h after the end of the infusion. Urine was collected from 0 to 2, 2 to 4, and 4 to 8 h following the same dose, and an aliquot was saved for determination of the ciprofloxacin concentration. Urine was also collected for 24 h prior to this dose for measurement of creatinine clearance (CLCR). Pharmacokinetic parameters were estimated by noncompartmental analysis. Mean maximum and minimum plasma ciprofloxacin concentrations were 4.2 +/- 1.1 and 0.70 +/- 0.55 microgram/ml, respectively. Mean values for clearance (CL), renal clearance (CLR), volume of distribution, terminal elimination rate constant, half-life (t1/2), and area under the concentration-time curve (AUC) were 29.1 +/- 17.5 liters/h, 13.5 +/- 10.1 liters/h, 1.75 +/- 0.41 liters/kg, 0.222 +/- 0.098 h-1, 4.5 +/- 3.9 h, and 20.7 +/- 16.6 micrograms.h/ml, respectively. CL was higher and t1/2 was shorter than noted in previous studies of acutely ill, hospitalized patients. A good correlation was noted between creatinine clearance CL(CR) and both total ciprofloxacin CL (r = 0.85) and CLR (r = 0.84). A moderate inverse correlation was noted between percent body surface area burned and total ciprofloxacin CL (r = -0.55). An AUC/MIC ratio above 125 SIT-1 (where SIT is serum inhibitory titer), which has been strongly correlated with clinical response and time to bacterial eradication, was achieved in five of eight patients (63%) with a MIC of 0.25 microgram/ml. At a ciprofloxacin dosage of 400 mg i.v. every 12 h, an AUC/MIC ratio above 125 SIT-1 would have been achieved in only two of eight patients (25%). We conclude that ciprofloxacin CL is highly variable, but generally increased, in burn patients compared with that in acutely ill, general medical and surgical patients. Because of an increase in CL, a ciprofloxacin dosage of 400 mg i.v. every 8 h is more likely to produce the desired response in burn patients than the same dose given every 12 h.

Adolescent↗
PubMed1996

[Helicobacter pylori eradication therapy with bismuth citrate/amoxycillin combination therapy].

The efficacy of a new combination preparation containing bismuth citrate and amoxicillin in one tablet was compared with the efficacy of bismuth citrate monotherapy in a randomised double-blind study on the eradication of Helicobacter pylori. The study involved 70 H. pylori positive (antrum biopsies showing a positive urease test) patients with non-ulcer dyspepsia and chronic gastritis. The treatment period was 14 days; 35 patients in group 1 received 2 tablets tid containing the bismuth citrate amoxicillin combination (BIAM tablet; 250 mg amoxicillin base and 120 mg bismuth); 35 patients in group 2 were treated with 2 tablets tid containing bismuth citrate (BI tablet; 120 mg bismuth). Total daily dose was therefore 1500 mg amoxicillin + 720 mg bismuth in group 1 patients resp. 720 mg bismuth in group 2 patients. 4 weeks after therapy H. pylori could not be histologically detected in the antrum of 22 patients (63%) in group 1 and 8 patients (24%) in group 2. Thus in group 1 (BIAM) a significantly higher eradication rate (p < 0.001) was shown than in group 2 (BI). Inflammation characterized by the infiltration of polymorphonuclear cells was significantly (p < 0.01) less pronounced in group 1 (BIAM) than in group 2 (BI) 4 weeks after the end of treatment. Gastrointestinal distress was quantified by evaluation of 13 different symptoms using a fourpoints scale at the beginning of the study and after 2 and 6 weeks. The sum of scores decreased by 81% in group 1 (BIAM) and 71% in group 2 (BI) after 6 weeks.

Adult↗
PubMed1987

Subfascial lifting.

The authors demonstrate by anatomical dissection that inaccuracies made by classical anatomists have worried plastic surgeons for many years. They demonstrate that continuity between the parotid fascia and the fibrous platysma has not been recognized. In addition, anatomists in the past have not been aware that the platysma is a unique type of fasciomuscular layer because in contrast to conventional anatomical opinions, the platysma has no bony attachment to the mandible.

Face↗
PubMed1987

[Use of polytetrafluoroethylene (Gore-Tex E-PTFE Soft Tissue Patch) for suspension of former facial paralysis and as reconstructive tissue].

The insertion of autogenous fascia lata to suspend the paralyzed cheek and lips remains one of the most widely practiced procedures in correction of long term paralysis of the lower facial muscles. For 34 months we used thin layers (1 mm) of expanded polytetrafluoroethylene (E-PTFE Gore-Tex Soft Tissue Patch) to replace autogenous fascia lata, in 20 patients, with satisfactory results. 13 patients were treated by classical techniques of insertion-suspensions of the paralyzed side with a perioral loop and slings of PTFE suspended to the zygomatic arch and the infraorbital rim, by way of nasolabial angle or rhytidectomy incisions. In 7 patients, an eyelid suspension was performed with PTFE by Arion's technique, but by replacing the classical silicon thread by E-PTFE and transposing the medial part of the temporalis muscle on the external canthus, and fixing the lateral end of the sling to the muscle. This technique assures a good corneal coverage with healing of the previous ulceration and allows a voluntary occlusion of the eyelids. The PTFE soft tissue is notably successful as an implant. This biocompatible material shows excellent tissue tolerance, the porous microstructure encouraging tissue attachment and infiltration. E-PTFE holds its shape, resists to infection, and permits a notably reduction of the hospitalization because it avoids a second surgical site. We have experience of the material as a reconstructive substance in 6 cases of either bone or subcutaneous deficits, where no other satisfactory solution was available. Is these cases our follow-up is 18 months.

Biocompatible Materials↗
PubMed1986

Effect of liver function on the metabolism of prednisone and prednisolone in humans.

The systemic availability of total prednisone and unbound prednisolone, and the urinary excretion of 6 beta-hydroxyprednisolone, were measured after an oral dose of prednisone and an i.v. dose of prednisolone in 22 patients covering a wide range of liver function (galactose elimination capacity ranging from 3.3 mg/min X kg body wt to 9.2 mg/min X kg body wt). The area under the plasma concentration versus time curves of prednisolone and of prednisone decreased with increasing galactose elimination capacity. This dependency of the steroid concentrations on liver function was attributed to a decreased metabolic clearance and not to an increased systemic availability of the steroid given p.o. in patients with impaired liver function. The fractional excretion and the fractional clearance of 6 beta-hydroxyprednisolone declined with decreasing metabolic clearance rate of prednisolone or with decreasing galactose elimination capacity. Thus, the enzymes involved in the 6 beta-hydroxylation are not spared as liver function declines, and the exposure to the biologically active unbound prednisolone is increased in patients with impaired liver function in relation to the amount of prednisone or prednisolone administered.

Adult↗
PubMed1986

Effect of dietary caffeine on airway reactivity in asthma.

The potential influence of dietary caffeine on bronchoprovocation challenges with carbachol was examined in 7 patients with asymptomatic asthma. In a double-blind fashion placebo or caffeine (6 mg/kg body weight; equivalent to approximately 4 cups of coffee) solved in orange juice was administered, and carbachol challenges were performed. The average peak serum concentration achieved 60 min after dosing was 7.6 +/- SD 2.1 mg/l. These caffeine levels did not produce any appreciable attenuation of the bronchoconstrictor response to carbachol inhalations. It thus appears that dietary caffeine is barely a cause of erroneous interpretations of bronchoprovocation challenges with carbachol.

Administration, Oral↗
PubMed1986

[Nasal reconstruction using the Converse frontal flap or a Washio retroauricular flap. Technical notes].

14 cases of nasal reconstruction by the Converse Scalping Flap or the Washio Temporo-auricular flap technique, over three years, led us to point out details necessary to insure the quality of the results. In particular, the Converse Flap must be thin; it never needs bone neither cartilage reinforcement when used in reconstructions of the two inferior third of the nose. The pedicle weaning method described allows the replacement of the scalp on thirteenth day. New data for the Washio technique are as following: --The mastoidian skin and not the retro-auricular skin must be used; --The back-cut of the scalp follows the AC line dating from three fixed points: A = helix root B = end of incision on the frontal hairline vertically to the fronto-orbital suture, and AB = AC = BC. This new data seem to warrant the fiability of the Washio flap, however the latter cannot dethrone the Converse flap, king flap of medio-facial reconstructions.

Humans↗
PubMed1985

[Quantification of the drug-metabolizing enzyme system in liver diseases: a comparison between antipyrine saliva clearance and the aminopyrine breath test].

The metabolic activity of the hepatic cytochrome P450 system was studied in 53 ambulatory subjects. 18 of these were cirrhotics and 23 had non-cirrhotic liver disease, documented by biopsy, serologic, ultrasound or computerized tomography findings, and characterized by quantitative liver function tests, such as galactose elimination capacity and indocyanine green fractional clearance. For comparison, 12 normal control subjects were also included. All subjects were given 10 mg/kg body weight antipyrine and saliva concentrations determined with an HPLC-method at 24 and 48 hours after dosing. Antipyrine saliva clearance (ASC) was calculated according to a two-point method (Cl1), and compared with a one-point method (Cl2) using the 24 h sample only. These subjects also underwent an aminopyrine breath test (ABT), breath samples being collected at regular intervals during 60 minutes following injection of a tracer dose of 1.5 muCi (14C-dimethylamino)antipyrine. Cl1 and Cl2 correlated strongly (r = 0.93). On the basis of smaller variations (particularly in control subjects), better definition of disease severity and convenience and time saving, Cl2 is to be preferred. Comparison of Cl2 with ABT showed that both procedures apparently quantify overlapping enzymatic activities. However, the relationship between Cl2 and ABT values, albeit highly significant (r = 0.72), suggests that only about half of the variables are subject to the same determinant. In addition, a positive intercept of the regression line extrapolated to the Cl2 axis points to quantitatively important extrahepatic breakdown of antipyrine. The results suggest that, in view of the wide variation in normal values (presumably in part influenced by exogenous pollutants), ASC only provides an approximation of hepatic metabolic activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Experience with collagen injection for the correction of contour deficiencies.

The author reports on the successful use of collagen injections after surgery for the correction of inter-superciliary lines and missing tissue lesions after rhinoplasty. Less successful results were obtained with naso-labial lines or lesions of excess tissue after rhinoplasty. Caution is advised in the use of collagen injections for congenital lesions.

Collagen↗
PubMed1984

Parotid fascia and face lifting: a critical evaluation of the SMAS concept.

Classical anatomists were mistaken in their description of the parotid and masseteric regions. According to their description, the fascia superficialis (or SMAS) would be in continuity with the platysma. Data from fresh cadaver dissections, histology, and embryology indicate, on the contrary, that it is the parotid fascia, which is continuous with the platysma. Comparative anatomy provides further confirmatory evidence, demonstrating that the parotid fascia is only the uppermost part of a muscle that has undergone fibrous degeneration. This muscle is the "primitive" platysma. In consequence, the sub-SMAS dissection plane is too superficial and creates a purely fatty flap. Conversely, deep dissection below the parotid fascia (and therefore below the primitive platysma) respects the true anatomic features and guarantees the solidity of the flap and the safety of the facial nerve.

Animals↗