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H Ditschuneit

Publications and source records attributed to H Ditschuneit.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Exclusion diet in Crohn disease: a controlled, randomized study].

In a controlled study patients with Crohn's disease received an exclusion diet or an diet low in refined carbohydrates and rich in fiber. A total of 26 patients was observed for 1 year. The exclusion diet was not significantly superior to the standard diet with respect to the clinical course (Crohn's disease activity index according to Best or van Hees) or laboratory parameters of inflammatory activity. During dietary counselling relapses were infrequent and symptoms improved in both dietary groups.

Crohn Disease↗
PubMed1990

[Nucleation time and age in patients with gallstones].

The relationship between nucleation time (NT), total lipid concentration (TLC) and age was studied in a group of 45 gallstone patients (10 male, 35 female, age 50.1 +/- 14.5 yrs). Bile was obtained by direct fine needle puncture of the gallbladder under local anaesthesia and sonographic monitoring. There was a positive correlation between age and nucleation time (r = 0.626, p less than 0.001), in addition to a negative correlation between age and total bile lipid concentration (TLC) (r = -0.414, p = 0.005). The negative correlation between age and TLC indicates that gallbladder's ability to concentrate the bile decreases significantly with age. It is possible that the decreased concentration is a result of the chronic pathogenetic effects of gallbladder stones. Practically all patients showed a prolonged nucleation time after the 60th year (11.54 +/- 5.50 vs. 2.65 +/- 2.52 days). This would seem to indicate that these patients suffered primarily from bilirubin or calcified stones, currently unsuited for conservative therapy methods.

Adult↗
PubMed1990

[Preventing the recurrence of common bile duct calculi following endoscopic papillotomy with ursodeoxycholic acid].

The effect of ursodeoxycholic acid on recurrence prevention of choledochal calculi after endoscopic sphincterotomy (EPT) was evaluated in 46 patients, whose bile duct stones had been removed endoscopically. 22 patients received 500 mg of ursodeoxycholic acid once a day, 24 patients received placebo. 1 recurrent stone could be detected in the ursodeoxycholic acid treated group 19 months after EPT, whereas 4 recurrent stones occurred in the placebo group about 16 months after EPT. Cholesterol saturation index decreased significantly by the ursodeoxycholic acid treatment 12 and 24 months after EPT (0.93 +/- 0.17 vs. 0.69 +/- 0.12 vs. 0.72 +/- 0.07). The nucleation time increased statistically significant from 9.0 days to 20.4 (12 months) and 17.7 (24 months) days, respectively. Obviously, pharmacological effects of ursodeoxycholic acid exist which modify important processes in the gallstone's pathogenesis.

Aged↗
PubMed1990

Relationship between pancreatic function and pain in chronic pancreatitis.

The association between pain and exocrine pancreatic function was re-evaluated in 56 patients with chronic pancreatitis to see if residual function of the gland may evoke outflow obstruction resulting in pain. No significant differences were found in the degrees of pancreatic dysfunction among three groups with different degrees of pain (no pain, n = 7; moderate pain, n = 21; and severe pain, n = 28), but patients with more impairment of exocrine pancretic function tended to have less pain. In patients with no pain the mean (SD) peak serum concentration of fluorescein was 2.0 (0.2) micrograms/l, in those with moderate pain it was 2.6 (0.1), and in those with severe pain it was 3.4 (0.1). No significant differences were found between the degree of pain and the duration of the disease, which was 5.5 (0.3) years in the group with no pain, 3.5 (0.2) in patients with moderate pain, and 3.8 (0.1) in those with severe pain. We conclude that outflow obstruction may affect some patients, but is not the only cause of pain. Patients with severe pancreatic dysfunction and steatorrhoea often present with pain, so either obstruction of the residual secretions, or inflammatory activity impinging on nerve endings in fibrotic tissue, may also cause pain. The causes vary, and there is often more than one, so optimal management implies thorough investigation of each patient and long term follow up.

Adult↗
PubMed1989

[Bismuth aluminate in gastroenterology. Therapeutic effects in chronic erosive Campylobacter pylori-associated gastritis].

14 patients with epigastric pain and chronic active gastritis as well as endoscopically proven erosions underwent an open therapeutic trial with bismuth aluminate (3 x 300 mg/day) for three weeks. Prior to and after treatment five biopsy specimens were taken from the antral mucosa 2 and 4 cm proximal to the pylorus for histological scoring of inflammatory activity and C. pylori detection, for urease quick test (CUT) and culture. Before treatment C. pylori was detected histologically and by CUT in all patients, whereas in culture, C. pylori was not detected in one case. After three weeks of treatment, 9 patients (64%) were C. pylori-negative in culture, and 8 patients (57%) had negative results both on histology and CUT. In 86% (12 patients) chronic erosions were no longer detectable and histological evidence of inflammation was reduced (p less than 0.01). All patients reported symptomatic relief. Complete elimination of C. pylori was observed in just over half the patients. These results confirm the effectiveness of bismuth aluminate in the short-term treatment of chronic active gastritis.

Adult↗
PubMed1989

[Drug cholelitholysis and the nucleation time].

Nucleation time (time elapsed until first appearance of cholesterol crystals in incubated bile fluid) and the lithogenic index were measured on 25 patients (aged 45.1 +/- 16.8 years; Broca index 106.7 +/- 4.2%) with radiolucent gallstones, before receiving daily 500 mg chenodeoxycholic acid and ursodeoxycholic acid orally. The nucleation time in the group of nine patients in whom complete lysis was achieved was 4.7 +/- 0.8 days, compared with 15.0 +/- 2.2 days in those with only incomplete lysis (P less than 0.001). There was no statistically significant difference between the two groups as to age, Broca index, lithogenic index and biochemical values. Thus the determination of nucleation time can contribute to distinguishing between responders and nonresponders to oral treatment for dissolving gallstones and may improve the success rate of the method.

Adult↗
PubMed1989

Effect of antacid treatment on endogenous prostaglandin synthesis in human antral and duodenal mucosa.

Using 14C-labeled arachidonic acid as precursor for in vitro prostaglandin synthesis, the effect of an antacid containing Al (OH)3, Mg(OH)2 and CaCO3 on endogenous prostaglandin synthesis was investigated in antral and duodenal mucosa of healthy volunteers. After three weeks of treatment with a high-dose antacid, there was no detectable change in the total capacity of the mucosa for prostaglandin synthesis, but the prostaglandin profile was markedly altered. The relative amounts of PGE2 and PGF2 alpha synthesized by antral and duodenal mucosa increased at the expense of the prostaglandins A2/B2, thromboxane A2, and prostacyclin. In a short-term study, this change was not observed following a single antacid dose within 1 hr after application. It is concluded that long-term antacid treatment may alter the prostaglandin pattern formed by gastroduodenal mucosa and this may be related to its therapeutic effect.

Adult↗
PubMed1989

Cyclosporin A treatment in inflammatory bowel disease.

The effect of cyclosporin A in acute and chronically active inflammatory bowel disease was tested in 11 patients with Crohn's disease and two with ulcerative colitis who had exhibited a poor response to at least eight weeks of conventional therapy. Trough levels of the drug in the therapeutic range were obtained in 12 of 13 patients. Cyclosporin A, which was usually added to the continued previous medication, including corticosteroids (11 of 13) or metronidazol (1 of 13), prompted an apparent clinical improvement in all but one patient. In six of the nine Crohn's disease patients with an initial Best index of greater than 150, a definite fall by at least 100 points was observed after 2-10 weeks of treatment, but the van Hees index declined only in two patients. All four patients with chronic perineal fistulation experienced symptomatic relief. Both patients with ulcerative colitis had a clinical remission. Erythrocyte sedimentation rate or serum albumin improved in eight of 13 patients. However, two of the nine responders with Crohn's disease relapsed during cyclosporin A therapy and three immediately after the medication was discontinued. Common side effects included hypertrichosis, tremor, and hyperesthesia; hypertension and epigastric pain each occurred only in one patient.

Adrenal Cortex Hormones↗
PubMed1989

Long-term effect of growth promoting conditions on the exocrine pancreas of rats.

Pancreatic adaptation following prolonged exposition to growth promoting conditions (protease inhibitor feeding, B II subtotal gastrectomy, subtotal colectomy) was studied in rats. Fifty male Wistar rats were divided into 5 groups: controls (n = 10), sham-operated (n = 10), low dose protease inhibitor feeding (n = 10), B II subtotal gastrectomy (n = 10), and subtotal colectomy (n = 10). After 4 mo a significant increase in pancreatic wet wt and DNA content was observed in rats after protease inhibitor feeding (p less than 0.01), B II gastrectomy (p less than 0.01), and subtotal colectomy (p less than 0.05). Pancreatic total protein and lipase content were significantly increased in these three groups. Amylase and trypsin content increased after feeding the protease inhibitor (p less than 0.01) and following B II subtotal resection (p less than 0.01) but were unaffected after subtotal colectomy. Comparing the long-term effects (4 mo) with our previously published short-term data (4 wk) under the same experimental conditions, pancreatic trophism after 4 mo is less pronounced but characterized by a change in the enzyme composition with an increase in pancreatic lipase content.

Adaptation, Physiological↗
PubMed1989

Alimentary tract and pancreas. Stimulation of mucosal prostaglandin synthesis in human stomach and duodenum by antacid treatment.

The effect of a low dose antacid treatment on mucosal prostaglandin metabolism was studied in 15 healthy volunteers. A daily dose of 46 mmol (= 138 mval) Al(OH)3 and 42 mmol (= 84 mval) Mg(OH)2 with a titrated in vitro neutralising capacity of 272 mval of H+ was given for three weeks. Total prostaglandin formation and the prostaglandin profile as well as the degradation of PGE2 were assayed by incubating homogenates of endoscopic biopsies from antral and duodenal mucosa with the precursor (14C)arachidonic acid. Total prostaglandin synthesis in antrum (623 (110) pmol/mg protein) and duodenum (432 (72) pmol/mg) was stimulated after three weeks administration of low dose antacids by 176% (p less than 0.05) and 154% (p less than 0.05), respectively. An untreated control group exhibited no significant changes. In contrast, the prostaglandin profile showed only a small increase of the prostacyclin metabolite 6-keto PGF1a (p less than 0.05) at the expense PGD2. PGE2 catabolism was unaffected. This enhanced activity of mucosal prostaglandin cyclooxygenase might represent one possible mechanism of action of a low dose antacid treatment.

Aluminum Hydroxide↗
PubMed1989

Role of primary and secondary bile acids as feedback inhibitors of bile acid synthesis in the rat in vivo.

The effect of various primary and secondary bile acids on the rates of synthesis of all major bile acids was studied in the live rat with an extracorporal bile duct. Bile acid synthesis was determined using HPLC based on mass or by isotope dilution. Derepressed rates of bile acid synthesis (30-54 h) were inhibited by an infusion of taurocholic acid only at a supraphysiological dose of 500 mumol/kg per h, but not at 300 mumol/kg per h, which approximates the initial bile acid secretion (250 mumol/kg per h). When administered together with taurocholic acid (200 mumol/kg per h) only a high dose of taurochenodeoxycholic acid (100 mumol/kg per h) decreased taurocholic but not tauromuricholic or taurochenodeoxycholic acid synthesis. The only bile acid suppressing taurocholic acid (36-71%) and taurochenodeoxycholic acid (up to 33%) formation at an infusion rate close to the normal portal flux was deoxy- or taurodeoxycholic acid at 15-50 mumol/kg per h. It may be concluded that deoxycholic acid and possibly other secondary bile acids are much more potent inhibitors than primary bile acids.

Alanine Transaminase↗
PubMed1989

[Pathophysiology of cholesterol gallstones].

Cholelithiasis is a civilization-related disease with multifactorial causation. The supersaturation of the bile with cholesterol is a deciding risk factor, which, however, does not lead to gallstone formation in each individual case. The connection between supersaturated bile and the formation of stone whose primary constituent is cholesterol, are the cholesterol-monohydrate crystals. Several risk factors lead to cholesterol supersaturation of the bile. Other risk factors induce or maintain the nucleation of the cholesterol crystals. In the following paper the nucleating and inhibiting factors and the pathophysiology of cholesterol gallstones will be discussed.

Bile Acids and Salts↗
PubMed1989

Gastric metaplasia and Campylobacter pylori in duodenal ulcer disease: an ultrastructural analysis.

An ultrastructural analysis was carried out on duodenal mucosa specimens, obtained during duodenoscopy from the edge of ulcers and distal duodenal cap mucosa in 42 patients with active duodenal ulcer disease, and in 12 controls. In 18 of 42 patients (43 p. 100), Campylobacter pylori was found in duodenal mucosa but not in controls (chi 2 = 5.91, p less than 0.05). In all 42 cases, gastric-type surface mucus cells were seen at the edge of the ulcer crater, and in 38 of the patients (90 p. 100) these metaplastic cells were also seen in the distal duodenal cap. C. pylori was always localized within the mucus layer, frequently in the intercellular spaces and, in 4 of 18 cases (22 p. 100), within the cytoplasm. C. pylori was detected exclusively in the proximity of gastric type metaplastic surface mucus cells with apparent fusion of membranes. It is suggested that the metaplastic surface mucus cell in the duodenal epithelium of patients with active duodenal ulcer disease is the target cell for colonization by C. pylori.

Adult↗
PubMed1989

[Effect of omega-3-fatty acids on biliary lipids and lithogenicity].

Until now no studies are available about the influences of omega-3-fatty acids on biliary lipids in men. The effects of 1.5 g omega-3-fatty acids per day on biliary lipid concentration and composition were studied in 13 male healthy persons over six weeks. Biliary cholesterol concentration decreased from 5.4 +/- 0.53 mol% to 3.7 +/- 0.30 mol% (25%) statistically significant. Phospholipids and bile acids remained unchanged. Cholesterol saturation index (CSI) was lowered from 1.13 +/- 0.12 to 0.85 +/- 0.06 (p less than 0.05). Bile acid composition and conjugation rates were unchanged. No significant side effects could be observed. Substitution of omega-3-fatty acids induced in healthy male persons a decrease of biliary cholesterol and lithogenicity.

Adult↗
PubMed1989

[Changes in biliary lithogenicity caused by 4 weeks' weight reduction].

In 2 of 12 patients (16.6%) cholesterol monohydrate crystals occurred in duodenal bile samples after a 4 weeks fasting period (452 kcal/day). Cholesterol monohydrate crystals could be observed until recently mainly in patients with cholesterol gallstones. Therefore, this finding indicates increased biliary lithogenicity despite a non statistical decrease in CSI from 1.35 +/- 0.35 to 1.19 +/- 0.64. Presumably the increased lithogenicity may be caused by an increased glycoprotein concentration and an improvement in gallbladder contractility. Short time fasting obviously will be a risk factor for the development of gallstones, if weight and metabolic normalisation cannot be achieved.

Adult↗