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Biomedical subjects

H D Janisch

Publications and source records attributed to H D Janisch.

At least 19 recordsLinked to original sources
PubMed2000

Eradication of Helicobacter pylori with pantoprazole and two antibiotics: a comparison of two short-term regimens.

BACKGROUND: High rates of Helicobacter pylori eradication can be achieved by combining proton pump inhibitors with two antibiotics. However, in the search for an optimal therapy a direct comparison of different regimens is necessary. METHODS: For this open study, 331 patients with duodenal ulcer were screened and randomly allocated to either pantoprazole 40 mg b.d., clarithromycin 500 mg b.d., and metronidazole 500 mg b.d. (PCM) or pantoprazole 40 mg b.d., amoxycillin 1000 mg b.d., and clarithromycin 500 mg b.d. (PAC) for 7 days. Both combinations were followed by a 7-day therapy with pantoprazole 40 mg o.d. alone. Eradication of H. pylori was assessed by use of a 13C-urea breath test 4 weeks after the intake of the last medication. RESULTS: Eradication rates were 90% in intention-to-treat patients from the PCM (132 out of 147; 95% CI: 84-94%) and the PAC group (135 out of 150; 95% CI: 84-94%). H. pylori was eradicated in 112 out of 117 per protocol patients of the PCM group (96%; 95% CI: 90-99%) and in 119 out of 126 patients of the PAC group (94%; 95% CI: 89-98%). Rapid relief from ulcer pain and a decrease in the mean intensity of other gastrointestinal symptoms was observed. Sixty-nine patients reported adverse events, none of which were related to the intake of pantoprazole. Four serious adverse events, none related to the trial medication, were observed. CONCLUSIONS: Both pantoprazole-based short-term triple therapies are highly effective and well-tolerated treatment regimens in the eradication of H. pylori.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1990

[Effect of nitrendipine on the function of the upper gastrointestinal tract].

A double-blind crossover-trial comparing the influence of orally administered nitrendipine and placebo on the function of the upper gastrointestinal tract was carried out in ten healthy volunteers. Esophageal motility, intestinal transit time, size and motility of the gallbladder, serum gastrin levels and gastric secretion (basal and after stimulation with pentagastrin) were determined. No statistically significant differences between nitrendipine and placebo could be observed. Most parameters remained unchanged in both groups. Serum gastrin levels slightly increased after nitrendipine but did not exceed the normal range. The results demonstrate that nitrendipine given in an antihypertensive dosage, in contrast to other calcium antagonists, does not influence the function of the upper gastrointestinal tract.

Adult↗
PubMed1990

[Metoclopramide antagonizes dopamine-induced inhibition of lower esophageal sphincter pressure in the awake beagle].

Different contradictory results, even in the same species of the DOP-effect on LESP have been reported. The aim of the present studies was to evaluate the effect of DOP on LES in purebread male beagles and whether in could be antagonised by the DOP-antagonist MCP. The LESP in beagles is sensitive to dopamine (DOP) and its "antagonist", metoclopramide (MCP). MCP raised the inhibited LESP after DOP-infusion in vivo, while it failed to change DOP-induced relaxation of opossum LES in vitro [1]. Data obtained after monotherapie with MCP did not exceed LESP-response to MCP after DOP-pretreatment. DOP applied as background counter-inhibition could be used to correct interdigestive phasic changements of LESP in order to reach a stable starting-point to investigate the action of LESP-stimulating compounds pharmacomanometrically. Due to DOP reflux-facilitating side effect via its decrease of LESP, large doses of DOP, as used in the intensiv care unit, should be administered together with sphincter-strengthening agents or antacid compounds.

Animals↗
PubMed1989

[Determination of gastric bicarbonate secretion in the human without acid suppression].

Gastric CO2/HCO3 was determined in absence of simultaneous inhibition of acid secretion by intra- and extragastric pCO2/pH measurements in 23 persons and calculated using the equation of Henderson-Hasselbalch. pCO2 was measured with use of a new electrode. The characteristics of the CO2 selective electrode membrane were tested in vitro. The CO2 selective membrane proved to be stable against 0.1 n HCl, gastric fluid with a pH of 1, and bile as well as mechanical irritations. 96.8 +/- 0.52% of given amounts of bicarbonate were detected in test fluids ranging in pH from 2.5-7.1. In gas and fluid, a linear relationship between given and measured bicarbonate of y = 0.97 x +1.03 with a correlation coefficient of 0.99 was observed. In vivo at pH less than 6, the intragastric pCO2 was significantly higher than that in venous blood. CO2 diffusion could be prevented by equilibration of intragastric pCO2 with venous pCO2. pCO2 was then measured in fluid as well as in reaspirated gas. Thus 94.6 +/- 8.8%, HCO3- that had been instilled intragastrically, could be detected. Without equilibration and resultant volume increase of the gas phase, bicarbonate secretion was 296.4 +/- 41.9 mumol/h under basal conditions and 520.8 +/- 252.8 mumol/h after acid stimulation. With equilibration, a bicarbonate secretion of 574.4 +/- 66.7 and 754.4 +/- 81.2 mumol/h was observed during basal and stimulated acid secretion. Our results indicate that bicarbonate measurements in absence of acid suppression require determination of CO2 in the fluid as well as in the gas phase.

Bicarbonates↗
PubMed1989

[The diagnostic value of serum PABA determination in pancreatic disease and in relation to anticholinergic medication].

PABA-serum and urine-concentration were studied in patients with normal, pathologic and pharmacologically inhibited pancreatic function. Secretin-pancreozymine test was selected as reference method. In patients with normal pancreas function and volunteers, PABA-serum-concentration was characterized by a rapid increase during the first 1 1/2 hours. A maximum increase of 32.42 +/- 10.04 mumol/l was reached after 90 minutes. In patients with exocrine pancrease insufficiency, difference to the control group was greatest after 30, 60, 90, and 120 min. Pharmacologic inhibition of the exocrine pancreas using pirenzepine also resulted in a significantly reduced PABA-serum-concentration after 30, 60 and 90 min. In correspondence to the delayed and smaller serum PABA increase, urine-PABA-concentrations were also diminished. Our results indicate that the optimal interval to differentiate between normal and impaired pancreas function with use of serum PABA determination is at 90 min after test begin.

4-Aminobenzoic Acid↗
PubMed1989

Cisapride-cimetidine interaction: enhanced cisapride bioavailability and accelerated cimetidine absorption.

The pharmacokinetic interaction between the gastrointestinal motility-stimulating substance cisapride and the H2-antagonist cimetidine was examined in 8 healthy volunteers (25 +/- 2 years of age). Steady-state kinetics of both substances were investigated after separate 1-week treatments of oral cisapride, 10 mg t.i.d., cimetidine, 400 mg t.i.d., and the two drugs combined. Cimetidine increased the cisapride peak plasma concentration from 58 +/- 25 ng/ml to 84 +/- 19 ng/ml (p = 0.01) and AUC0-24 from 509 +/- 289 ng/ml.h to 738 +/- 148 ng/ml.h (p = 0.02). Cisapride shortened the time to the peak concentration of cimetidine from 1.3 +/- 0.6 h to 0.6 +/- 0.2 h (p = 0.005) and reduced the cimetidine AUC0-24 from 11.0 +/- 2.3 micrograms/ml.h to 9.0 +/- 2.0 micrograms/ml.h (p = 0.05). It is concluded that cimetidine inhibits cisapride metabolism, whereas cisapride enhances the gastrointestinal absorption of cimetidine.

Adult↗
PubMed1988

Cisapride versus ranitidine in the treatment of reflux esophagitis.

The healing effect of the prokinetic drug cisapride (10 mg q.i.d.) on esophageal lesions, and its therapeutic control of gastroesophageal reflux symptoms were compared with the effects of the H2-antagonist ranitidine (150 mg b.i.d. + placebo b.i.d.) in a double-blind trial. In each group, 28 patients with Savary-Miller Grade I or II esophagitis were treated for 6 or 12 weeks. At the end of treatment, follow-up endoscopy showed that mucosal lesions were absent in 89% of the cisapride patients and in 79% of the ranitidine patients. In addition, 86% and 82% of the patients in the cisapride and the ranitidine group, respectively, had no, or only mild, reflux symptoms. Minor side effects were experienced in both groups. From these data, cisapride appears to be as effective as ranitidine in controlling reflux symptoms and in promoting the healing of mucosal lesions in milder forms of reflux esophagitis.

Cisapride↗
PubMed1988

[Various effects of secretin and pentagastrin on peripheral venous blood gas analysis].

Until recently, vasomotor effects of gastrointestinal polypeptide hormones have been observed primarily in animal experimentation. 33 volunteers were observed to survey the influence of secretin (1 CU/bw./h) and pentagastrin (0.75 micrograms/bw/h) on peripheral blood gas concentrations and on the acid/base balance. Compared to a control group, secretin caused a significant increase in pO2 and in O2 saturation (p less than 0.05). In contrast to secretin, pentagastrin caused a significant decrease in the pO2 as well as in the O2 saturation (p less than 0.05) pCO2, pH and HCO3 were not significantly affected by either secretin or pentagastrin. These results can be interpreted as possible direct vasodilatative/constrictive as well as local metabolic effects of secretin and pentagastrin.

Adult↗
PubMed1986

Changes in the blood gas concentration caused by secretin and cholecystokinin. Indication of a vasomotor effect?

The assumption that secretin has a general vascular effect led to an investigation of the blood gas level in the peripheral veins and the acid/base balance under the influence of secretin (1 CU/kg/h, 0-120 min) and cholecystokinin (CCK) (1 IU/kg/h, 60-120 min) in a group of 10 volunteers. Six of the volunteers were subjected to a randomized, cross-over NaCl infusion study. With a secretin infusion alone (0-60 min) there was a transient, significant rise in PO2 (p less than 0.01) and oxygen saturation (p less than 0.05), which was no longer detectable after 60 min (p greater than 0.05). With an additional administration of CCK (60-120 min) and in the follow-up phase of observation (120-180 min) there was a significant fall in both parameters (120 min: p less than 0.05, 180 min: p less than 0.01). PCO2, HCO-3, and pH remained unaffected. The isolated increase in PO2 and O2 saturation may be attributed to vasodilation induced by secretin. The drop in both parameters under the influence of an additional infusion of CCK and in the follow-up phase of observation is linked to a possible vascular effect of CCK.

Adult↗
PubMed1986

[Pathophysiologic principles of motility disorders of the esophagus].

In primary motility disorders of the esophagus the etiological factors and the pathogenesis of the disease are still unknown. Different mechanisms have been discussed but none of these was conclusive in respect to the origin of the disease. In patients with secondary motility disorders of the esophagus i. e. in diabetes and scleroderma the pathogenic mechanisms seems to be more obvious. Nerval and muscular involvement of the esophagus by the underlying disease leads to the motoric dysfunction of the organ. The manometric feature in these patients is often mimicking a primary motility disorder. In gastroesophageal reflux disease it is still unknown which factor is first in the vicious circle of the disease.

Animals↗
PubMed1985

[Absence of effect of secretin and cholecystokinin on plasma concentrations of vasoactive intestinal polypeptide and pancreatic glucagon].

There is little information about the effect of peptides on the VIPergic system. Reports of the influence of secretin and cholecystokinin (CCK) on pancreatic alpha cells are contradictory. With the help of volunteers we investigated the influence of a new synthetic secretin (1 CU/kg/h, 0 to 120 min) alone and in combination with GIH-CCK (1 IU/kg/h, 60 to 120 min) on the concentrations of VIP (n = 13), pancreatic glucagon (PG) (n = 15) and blood sugar (n = 10). 6 of the volunteers were subjected to a randomized cross-over NaCl infusion study. Neither secretin (0 to 60 min) nor secretin and CCK (60 to 120 min) infusion caused a significant change in VIP (31 +/- 3 vs. 34 +/- 4.5 pg/ml, mean +/- SEM, p greater than 0.05), PG (102 +/- 9 vs. 116 +/- 12 vs. 114 +/- 12 pg/ml, p greater than 0.05) or blood sugar (about 90 mg/dl) concentrations. There is no evidence of an influence of secretin and CCK on te VIPergic system and the pancreatic alpha cells.

Adolescent↗
PubMed1985

[Indication of the vasomotor effects of secretin and cholecystokinin by changes in blood gas concentration?].

The assumption that secretin has a general vascular effect led to an investigation of the blood gas level in the peripheral veins and the acid/base balance under the influence of secretin (1 CU/Kg/h, 0 to 120 mins) and cholecystokinin (1 IU/Kg/h, 60 to 120 mins) in a group of 10 volunteers. Six of the volunteers were subjected to a randomised crossover study under NaCl infusion. With a secretin infusion alone (0 to 60 mins) there was a transient, significant rise in PO2 (p less than 0.01) and oxygen saturation (p less than 0.05), which was no longer detectable after 60 minutes (p greater than 0.05). With an additional administration of cholecystokinin (60 to 120 mins) and in the follow-up phase of observation (120 to 180 mins) there was a significant fall in both parameters (120 min.: p less than 0.05, 180 min.: p less than 0.01). PCO2, HCO-3 and pH remained unaffected. The isolated increase in PO2 and O2 saturation may be attributed to vasodilation induced by secretin. The drop in both parameters under the influence of an additional infusion of cholecystokinin and in the follow-up phase of observation is linked to a possible vascular effect of cholecystokinin.

Acid-Base Equilibrium↗
PubMed1984

[Mesenteric lipodystrophy: differential diagnosis of a benign abdominal tumor].

In a clinical presentation of a patient with mesenteric lipodystrophy the usefulness of the two imaging procedures ultrasound and computeromography is firstly demonstrated. Both methods have proven as good means in early diagnosis and patients follow up. Combination of ultrasound and guided tumor puncture is able to establish diagnosis avoiding laparotomy. For the follow up of these patients ultrasound and computertomography are valuable.

Abdominal Neoplasms↗
PubMed1984

[Effect of synthetic secretin and GIH-cholecystokinin on serum gastrin levels].

In response to the report of a false-positive increase in serum gastrin with the use of natural secretin (Boots), 11 test persons were enlisted in order to examine the effect of a new synthetic secretin (Hoechst), both alone and in combination with natural CCK, on serum gastrin concentration. 6 of the test persons were subjected to a randomised cross-over study under NaCl infusion. Under secretin (0 to 60 minutes) there was a significant fall in gastrin from 32 +/- 2.3 pg/ml to 23 +/- 2 pg/ml (p less than 0.01). When CCK was also administered (60 to 120 minutes) the gastrin level increased to 46 +/- 3.5 pg/ml (75 versus 0 minutes: p less than 0.01), 75 versus 60 minutes: p less than 0.001). At the end of the infusion the gastrin level had fallen significantly once more to 21 +/- 2 pg/ml (135 versus 120 minutes: p less than 0.001, 135 versus 0 minutes: p less than 0.01). On the basis of in vitro studies -- which revealed a cross-reaction of 2.4% - the increase in gastrin under CCK is not regarded as being due to cross-reaction with CCK but rather to contamination by other peptides.

Adult↗