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Biomedical subjects

H Ditschuneit

Publications and source records attributed to H Ditschuneit.

At least 91 records · Page 5Linked to original sources
PubMed1988

[Bismuth subsalicylate treatment in chronic Campylobacter pylori-associated erosive gastritis].

In a prospective open study 21 patients with upper abdominal complaints and chronic active gastritis as well as endoscopically proven erosions were treated with bismuth subsalicylate (4 X 30 ml/day, corresponding to 4 X 314 mg Bi3+) for three weeks. In 20 patients (95%) Campylobacter pylori (CP) was found in at least two of three examinations (culture, CLO quick-test, special histology). After the treatment 17 of 21 patients (81%) were CP negative, and the clinical symptoms had gradually disappeared. The histologically demonstrated degree of activity had regressed significantly after the three-week treatment; in 90% of patients the inflammatory process had completely abated. These results demonstrate that bismuth subsalicylate is highly effective in the acute treatment of CP-associated chronic erosive gastritis.

Adult↗
PubMed1988

The Schilling test cannot be replaced by an absorption test with unlabeled vitamin B12.

It was the purpose of this study to evaluate the diagnostic usefulness of an oral absorption test using nonlabeled Vit B12 suggested by a commercial distributor as an alternative for the more expensive Schilling test (ST). Plasma levels of Vit B12 were measured with a commercial kit before and 4 h after oral administration of 1 mg Vit B12 in 32 normals, in 16 patients with normal ST, and in 14 patients with abnormal ST for determination of sensitivity and specificity with the ST as golden standard. In normals, a mean of 767 +/- 404 pg/ml before and 1096 +/- 776 pg/ml after oral Vit B12 with a mean increase of 331 +/- 453 pg/ml was measured. Because of the obvious large variation, no meaningful range for normal absorption could be established. In the two patient subsets, there was no Gaussian distribution of the results, with a meridian of Vit B12 increase after absorption of 142 pg/ml, range 27-2668 pg/ml, in the group with normal ST and a meridian of 244 pg/ml ranging from 40 to 2453 pg/ml in the group with abnormal ST. Statistical nonparametric analysis did not reveal any difference between the two groups. Assuming a minimum required increase of 100 pg/ml, as suggested by the kit distributor, a sensitivity of only 27% and a specificity of 75% was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Pathologic wall changes in the gallbladder in patients with gallstones and in healthy probands. Imaging using high frequency annular array sector transducers].

2154 computerized ultrasound diagnoses of 1623 patients were evaluated retrospectively from January 1st to October 31st 1987. The frequency of pathologic gallbladder wall changes in patients with stones and normal controls was examined applying 5 MHz annular array sector transducer. The occurrence of polyps, septae, sludge, kinking, carcinoma and adenomyomatosis was noted separately. The prevalence of polyps and septae in gallstone patients was increased fourfold if compared to the total number of examined patients. Sludge was found in 5.9% of gallstone patients compared to 2.2% in normal controls. Carcinoma and adenomyomatosis were present only in cases of cholelithiasis; the prevalence of these pathologic wall changes is obviously rare. The importance of polyps and septae in biliary lithogenicity is discussed.

Carcinoma↗
PubMed1988

Effects of microencapsulated vs. enteric-coated acetylsalicylic acid on gastric and duodenal mucosa: an endoscopic study.

Two preparations of acetylsalicylic acid (ASA) were tested for their effects on gastroduodenal mucosa in a randomized crossover double-blind study that involved 12 healthy volunteers. Medication M (Monobeltin) consisted of 1,050 mg ASA provided with an enteric coat and medication C (Colfarit) consisted of 1,000 mg of a microencapsulated ASA preparation. Both drugs were taken for 6 consecutive days each. Upper gastrointestinal endoscopy was performed before and 2 and 6 days after each medication. An interval of 10 days elapsed between one treatment and the other. Gastric lesions occurred in 10 of 12 subjects taking medication M and in 11 of 12 subjects taking medication C after 2 days and were present in all subject after 6 days. Duodenal lesions were seen only in subjects taking medication C. The degree of gastric mucosal lesions based on two grading scales was not significantly different between the two treatments. Neither of the two pharmaceutical formulations of ASA provided sufficient protection for the gastric mucosa.

Adult↗
PubMed1988

Chronic erosive gastritis--a therapeutic approach with bismuth.

37 patients with epigastric pain and chronic erosive gastritis underwent an open controlled therapeutic trial with bismuthsubsalicylate (BS). Group A (21 patients) was treated with BS, liquid, 4 X 314 mg for three weeks, group B (16 patients) with BS tablets, 3 X 300 mg for two weeks. A significant reduction of symptoms (p less than 0.001) and endoscopically assessed chronic erosions (p less than 0.001) was achieved in both groups. Campylobacter pylori was detected in 89% of the patients before treatment, but was absent in 78% of the patients after treatment. The histological grading of antral mucosa showed a significant reduction (p less than 0.001) of polymorphonuclear cell (PML) infiltration after two and three weeks treatment respectively. While in group A PML cells had disappeared from gastric mucosa in all but two patients, in group B 50% of the patients had some degree of PML cell infiltration left in the antral mucosa. This study confirms the beneficial effect of BS in the treatment of C. pylori associated active chronic gastritis and reemphasizes the pathogenetic role of C. pylori in this disease.

Adult↗
PubMed1988

Pathogenetic implications of ultrastructural findings in Campylobacter pylori related gastroduodenal disease.

There is now substantial evidence that Campylobacter pylori (Cp) is able to colonize the gastroduodenal mucosa and is responsible for active chronic gastritis, its role in duodenitis, gastric ulceration and duodenal ulceration is still under debate. Cp has a lot of characteristics which are prerequisites for a pathogen: the typical S-shape, the corkscrew-like movement and the powerful urease and protease enzymes. These features allow a rapid movement through the mucous layer to permit access to the apical membranes of the surface mucous cells. There they adhere directly to the membranes and induce several ultrastructural alterations: degeneration of microvilli, depletion of mucous granules and an increase in sialic-acid rich glycoproteins in the apical part of the cytoplasma. Cp weakens the tight-junction complex and is found between the cells and sometimes intracellularly. Cp is phagocytized by invading polymorphonuclear leukocytes and causes an intense inflammatory response. These observations clearly demonstrate pathological alterations which in the cellular level induced by Cp with the result of a disrupted mucosal barrier of the stomach and the duodenum.

Bacterial Adhesion↗
PubMed1988

[Nucleation time and lithogenic index in obese patients and in patients with cholecystolithiasis].

The gallbladder bile of obese patients without gallstones is supersaturated with cholesterol. The cholesterol saturation index (CSI, LI) of 27 obese patients was 1.32 +/- 0.2. The CSI of 24 normal weight gallstone patients was determined with 1.16 +/- 0.37 and is therefore not significantly different from CSI of obese stone free individuals. The supersaturated bile from obese patients does not accelerated the nucleation of cholesterol crystals. The nucleation time of obese persons was statistically significant longer (16.0 +/- 3.0 days) than in gallstones patients (6.0 +/- 0.78 days) (p less than 0.001). In 50% of the patients with gallstones cholesterol monohydratcrystals were present in the native gallbladder bilde, whereas such crystals are found in only 3.7% of the obese group. Liquid crystals occurred more frequently and in larger number in the bile of the obese patients. The stone forming potency of gallbladder bile can be estimated better by the determination of nucleation time and cholesterol crystals occurrence than by the calculation of the saturation index (CSI).

Adult↗
PubMed1988

[Dietary modification of bile lipids].

The average incidence of gallstones in european countries is about 25%. Excessive secretion of cholesterol into the bile can predispose to saturation and gallstone-formation. Obesity, overnutrition, diets rich in refined carbohydrates, diets high in cholesterol intake and poor in dietary fibre, lipid lowering drugs, age and female sex hormones are recognized causing increased cholesterol secretion into the bile. These metabolic consequences may predispose to a higher incidence of cholesterol gallstone than in normal persons. Taking all the results of the literature together patients with gallstones should be encouraged to take a low cholesterol, low calorie, low refined carbohydrate and high polyunsaturated fat diet rich in bran und vegetable fibre. Obese patients should reduce their body weight. These dietary recommendations should be given for patients with gallstones during bile acid therapy and after successful dissolution in order to prevent gallstone recurrence.

Bile↗
PubMed1987

Analysis of conjugated bile acids in human serum by high-performance liquid chromatography using post-column enzyme reaction and off-line fluorimetric determination.

An assay for glycine and taurine conjugates of cholic (GC, TC), chenodeoxycholic (GCDC, TCDC), deoxycholic (GDC, TDC) and ursodeoxycholic (GUDC, TUDC) acids in human serum by high-performance liquid chromatography using an immobilized 3-alpha-hydroxysteroid dehydrogenase post-column reaction and an off-line spectrofluorimetric detection is described. The detection limit is 0.2 microM. Recoveries of extraction and chromatographic analysis range from 89.50 to 91.68% and from 96.75 to 98.83%, respectively. The analysis in serum reveals a coefficient of variation for reproducibility between 16.2% for GC and 4.7% for TDC; inter-assay variability ranges between 4.06% for TCDC and 8.24% for TUDC.

Bile Acids and Salts↗
PubMed1987

[Conservative cholelitholysis in the calculus-congested gallbladder].

Daily administration of 500 mg ursodeoxycholic acid and chenodeoxycholic acid (divided into two doses, morning and evening, corresponding to 8.5 mg per kg body-weight and substance), all concrements in the gall-bladder were dissolved over a period of 14 months in a 60-year-old man for whom surgical treatment was contra-indicated because of severe coronary heart disease. This case illustrates that, in the face of a high operative risk, the attempt to dissolve stones in the gall-bladder by drugs is justified.

Chenodeoxycholic Acid↗
PubMed1987

[Campylobacter pylori--is there a connection with peptic ulcer?].

In 67 patients, mucosal biopsies were taken in gastroduodenoscopy and culture set up to demonstrate Campylobacter pylori. Campylobacter pylori was cultured from 91% of the patients with peptic ulcer, in 76% of patients with gastritis and in 28% of patients without histological detection of gastritis. Electron microscopic investigations of duodenal mucosa showed that this bacterium attaches to the metaplastic cells of the antral type. This cell type is regularly encountered in the duodenal mucosa in healing duodenal ulcer. The ultrastructural features permit a clear distinction between Campylobacter pylori and other Campylobacter species. Campylobacter pylori may possibly have a pathogenic effect on the mucosa owing to its penetration into the interstitial spaces between the cells and into the interior of the cells.

Adult↗
PubMed1987

Invasion of campylobacter-like organisms in the duodenal mucosa in patients with active duodenal ulcer.

The ultrastructure of campylobacter-like organisms found within duodenal biopsy specimens from 7 of 24 patients (28%) with active duodenal ulcer is described. Their curved shape and variable size are similar to what has previously been reported in descriptions of light microscopies. The organisms were found at the edge of active duodenal ulcers exclusively near neutral-mucous producing antral cells, to which they can adhere. The presence of these bacteria within cells and in the intercellular fluid implies that they can penetrate through the cell membrane or through tight intercellular junctions. The occurrence of these bacteria as well as numerous polymorphonuclear leukocytes in the afflicted regions suggests that the bacteria originally described by Warren and Marshall are indeed pathogenic and that their influence on ulcer healing should be included in designing treatment protocols.

Campylobacter↗
PubMed1987

Regulation of basal and insulin-stimulated glycogen synthesis in cultured hepatocytes. Inverse relationship to glycogen content.

Cultured rat hepatocytes were used to characterize the relationship between cellular glycogen content and the basal rate, as well as response to insulin of glycogen synthesis. Depending on the concentration of medium glucose, glycogen-depleted monolayers accumulated glycogen between 24 and 48 h of culture up to the fed in vivo level. Insulin at 100 nM stimulated glycogen deposition 20-fold at 1 mM and 1.5-fold at 50 mM glucose. The rate of further glycogen storage decreased with time and increasing glycogen content. In hepatocytes preincubated with 1-50 mM glucose during 24-48 h, short-term basal and insulin-dependent incorporation of 10 mM [14C]glucose into glycogen was inversely related to the actual cellular glycogen content. This was not due to different intracellular dilution of the label, since the specific radioactivity of UDP-glucose was similar in all groups. 125I-Insulin binding indicated that insulin receptors were also not involved in this phenomenon. An inverse relationship was also found between glycogen content and the stimulation of glycogen synthase I activity by insulin, whereas the basal activity of the enzyme was dissociated from the rate of incorporation of [14C]glucose. Basal net glycogen deposition at 10 mM glucose was also inversely related to cellular glycogen; however, no such relation was evident in the presence of insulin due to the overlapping inhibition of glycogenolysis. These studies suggest that the glycogen-mediated inhibition of the activation of glycogen synthase I is operative in the cultured hepatocyte and leads to an apparent inverse relationship between the actual glycogen content and basal as well as insulin-dependent glycogenesis.

Animals↗
PubMed1987

[Ultrasound guided fine- and coarse-needle puncture of the abdominal and retroperitoneal space].

Within a period of 21 months, 167 fine-needle and 86 cannula (1.67 mm external diameter) punctures of the abdominal or retroperitoneal space were performed under sonographic control. Sufficient material was obtained with 93.4% of fine-needle punctures. With regard to differentiation between malignant and benign lesions, fine-needle punctures had a sensitivity of 86% and specificity of 100%, if the material was examined by an experienced cytologist. Sensitivity dropped to 55,1% if the same material was interpreted by a less experienced cytologist, but specificity was still 98.1%. Sufficient material for histological examination was always obtained with the cannula, already at the first puncture. With cannula puncture there were two complications: bleeding requiring transfusion and peritonitis.

Abdomen↗
PubMed1987

Serum elastase 1 in inflammatory pancreatic and gastrointestinal diseases and in renal insufficiency. A comparison with other serum pancreatic enzymes.

Serum elastase 1 has been evaluated in 115 patients with pancreatic and nonpancreatic gastrointestinal diseases and in 36 healthy controls. Increased serum elastase 1 values were found in all 27 patients with acute pancreatitis. If the diagnostic cutoff was established as the 2-fold increase above the upper normal range, sensitivity of elastase 1 (100%) was superior to pancreatic lipase (90%), immunoreactive trypsin (87%) and pancreatic amylase (78%). Specificity was 96% for elastase 1 at this cutoff. No distinction was possible between edematous and necrotizing acute pancreatitis on the basis of peak serum elastase 1 concentrations. Among 32 patients with chronic pancreatitis increased serum elastase 1 values were found in 22% and decreased values in 16% of patients, showing a striking parallelism to serum values of pancreatic lipase and immunoreactive trypsin. Specificity, established in controls and 49 patients with different gastrointestinal diseases, was 77% for elastase 1, 76% for immunoreactive trypsin, 83% for pancreatic lipase and 91% for pancreatic amylase. In addition, we investigated 21 patients with severe chronic renal diseases. In patients with renal insufficiency elastase was increased in 33%, comparable to the frequency of increased amylase and pancreatic amylase serum levels, whereas immunoreactive trypsin was increased in 95%. Immunoreactive trypsin showed a significant correlation to creatinin serum concentration, whereas the other enzymes did not.

Acute Disease↗
PubMed1987

Pancreatic morphology and function in relationship to pain in chronic pancreatitis.

The correlation of pancreatic pain and the degree of morphological and functional changes was prospectively investigated in 64 patients (45 males, 19 females) with chronic pancreatitis. All patients underwent clinical examination and diagnostic investigations by means of endoscopic retrograde pancreatography (ERP), computed tomography (CT) and exocrine pancreatic function test (secretin-ceruletide; SC). The individual tests were performed within 4 weeks in all patients. No significant correlation was found between the degree of pain and the severity of ERP and CT findings. Severe pain was found in 62% of patients with advanced ductal changes, and in 41% of patients with advanced parenchymal lesions. 58% of patients with severe pain had marked exocrine insufficiency. Ductal changes characterized by obstruction of the main pancreatic duct were most frequently associated with severe pain (58%). Less often, severe pain was associated with duct dilatation (34%) or with slight duct changes (26%). Among parenchymal lesions as revealed in CT, large cysts were most frequently related to severe pain (62%). A notable finding was that 89% of patients presenting with calcifications in CT still experienced pain and 39% of them had severe pain. The combined diagnostic approach is useful for the individual therapeutic management, but does not provide insight into the mechanisms of pain in chronic pancreatitis.

Adult↗
PubMed1987

Prostaglandin synthesis along the gastrointestinal tract of the rabbit: differences in total synthesis and profile.

In the present study we systematically investigated the synthesis of prostaglandins in the mucosa and the muscle layer along the length of the rabbit gut. Homogenates of mucosa and muscle layer were incubated with (14C)-labelled arachidonic acid, and prostaglandin formation was determined using thin-layer chromatography. With respect to total prostaglandin synthesis the highest values in the mucosa were measured in fundus, antrum and colon, whereas the prostaglandin synthesis in the muscle layer was maximal in the small bowel, particularly the ileum. In the mucosa, the prostaglandins E2 and F2a predominated, and there were minor differences along the gastrointestinal tract. In the muscle layer of the stomach, high amounts of 6-keto prostaglandin F1a, the stable degradation product of prostacyclin were produced, while small and large bowel homogenates synthesized mostly F2a. Consistently the prostaglandins A2/B2 were a major product in most locations. In addition, PG E2 catabolism to 15-keto PG E2 and 13,14-dihydro-15-keto PG E2 in the absence of NAD was slow. No significant changes in total prostaglandin synthesis and prostaglandin profile were detected between 24 hrs fasted and normally fed rabbits at any part of the gastrointestinal tract.

Animals↗