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Biomedical subjects

H Erichsen

Publications and source records attributed to H Erichsen.

18 recordsLinked to original sources

Glutamine dipeptides-supplemented parenteral nutrition reverses gut mucosal structure and interleukin-6 release of rat intestinal mononuclear cells after hemorrhagic shock.

Glutamine is an essential substrate for gut mucosal structure, but the role for gut immune function is not fully known. To determine the effect on gut cytokine release in relation to bacterial translocation and gut morphology, a nonlethal hemorrhagic shock (30 min, 30 mmHg) was performed in male Wistar rats followed by 4 days of different way of feeding. A conventional total parenteral nutrition (TPN) solution was compared with an isocaloric and isonitrogenous TPN solution supplemented with alanin-L-glutamine and glycyl-L-glutamine. An enteral chow-fed control group was included. Gut mononuclear cells and splenic macrophages were obtained and endotoxin-induced supernatant tumor necrosis factor-alpha (TNF) and interleukin-6 (IL-6) bioactivity was measured. Histological specimen of the small bowel were taken and mesenteric lymph nodes (MLN) were separated. Enteral feeding following hemorrhagic shock was accompanied by a normal mucosal structure and no bacterial translocation could be detected. TPN was characterized by suppression of cytokine release in gut mononuclear cells and splenic macrophages compared with the enteral-fed control (p < .05). Decreased TNF and IL-6 release was associated with a significantly increased mucosal injury score (p < .05) and a high incidence of bacterial translocation to MLN (66%, p < .05 vs. control). Supplementation of glutamine-dipeptides did not prevent TPN-induced bacterial translocation to MLN (p < .05 vs. control) but significantly improved mucosal injury (p < .05 vs. TPN). Down-regulation of TNF release in TPN-fed rats could not be reversed by glutamine dipeptides while IL-6 release was significantly increased compared with TPN-fed animals (p < .05), and no difference to enteral-fed controls could be found. Enteral nutrition following hemorrhagic shock is superior to parenteral nutrition with regard to mucosal structure, cytokine release, and bacterial translocation. Supplementation of TPN with glutamine dipeptides could reverse TPN-induced suppression of IL-6 release and improved mucosal structure, which may be beneficial in various disease conditions in which TPN is an integrated part of patients management.

Animals↗

[Effect of postoperative endonasal mucous membrane care on nasal bacterial flora: prospective study of 2 irrigation methods with NaCl solution after paranasal sinus surgery].

BACKGROUND: Endonasal irrigation with saline solution is a widely used constituent of mucosal care after sinus surgery. This procedure could explain a repeatedly observed phenomenon: contamination of the endonasal mucosa by facultative skin pathogens from the palm during paranasal sinus irrigation. METHOD: For this reason the effect of nasal rinses with saline solution on the endonasal bacterial flora was investigated (use of so-called nasal douche [Siemens & Co., Bad Ems] compared to rinsing by hand). In 36 patients (23 m., 13 f., 36 +/- 19.5 years of age) with chronic sinusitis, a total of 288 swabs was collected before, during, and after surgery. The collected specimens were transferred to a Port-A-Cul transport medium and processed within four hours. RESULTS: Two hundred sixty-six cultures of 325 bacterial strains were aerobic (82%), while 59 were anaerobic (18%). Staphylococcus aureus (33%) and representatives of the Enterobacteriaceae family (31%) were the most common enriched germs. The number of times that enterobacteriaceae could be isolated was significantly (p < 0.05) lower (13%) when a nasal douche was used than when irrigation was done using the palm (38%). An irrigation technique-related effect was found on neither the spectrum of the pathagonic organisms nor the wound healing process. CONCLUSION: The frequent isolation of enterobacteria in nasal swabs of individuals rinsing by hand constitutes the difference between irrigation by nasal douche and by hand in the postoperative care of the endonasal mucosa. These pathogens can sustain the paranasal sinus system.

Adult↗

Gastroesophageal reflux disease. Acute and maintenance treatments with cimetidine.

The comparative efficacy of a 12-week acute treatment with 800 and 1600 mg cimetidine daily and the effectiveness of a 400-mg single-dose maintenance treatment versus placebo lasting 6 months were studied in a double-blind fashion in 30 and 24 patients, respectively, with gastroesophageal reflux (GER) disease. Cimetidine in a dose of 800 or 1600 mg daily resulted in a significant symptomatic improvement and a decrease in the extent of endoscopic esophagitis. An improvement in the gastroesophageal sphincter function during treatment was suggested by a significant decrease in the frequency of reflux, as evaluated by isotope scintigraphy. No significant differences were found between the two doses of cimetidine. The overall initial improvement tended to be maintained during maintenance treatment, but no significant differences were found between cimetidine and placebo. The present study thus supports the use of 800 mg of cimetidine daily for short-term treatment of GER disease but provides no support for maintenance treatment with a low dose. The study further suggests that cimetidine treatment, by reducing the tendency to GER, may induce long-lasting remission of the disease.

Adult↗

Scintigraphy, pH measurement, and radiography in the evaluation of gastroesophageal reflux.

Scintigraphy as a diagnostic tool has been explored in 69 patients with gastroesophageal reflux (GER) symptoms and endoscopic esophagitis. In all subjects the presence of reflux was also evaluated by radiography and intraesophageal pH measurements (standard acid reflux test). The overall sensitivity of scintigraphy (85.5%) was significantly higher than those of radiography (27.5%) and pH measurements (69.5%). Scintigraphy was performed with normal saline and with acidified orange juice as the transport medium for the isotope 99mTc. The yield of positive scintigrams was higher (22.3 to 61.1%, depending on the grade of endoscopic esophagitis) with the latter variant. Moreover, demonstration of spontaneous reflux was greatly facilitated by the acid scintigraphy. This was particularly obvious in the grade I esophagitis, in which the frequency of spontaneous reflux with the saline method was 3.4% and with the acid medium, 34.3%. Reflux (induced or spontaneous) was seen in 2 of 22 normal control subjects with the saline method and in 1 subject only with the acid method. On the basis of these findings, it is concluded that scintigraphy, especially the acid variant of the technique, is a valuable diagnostic procedure in GER disease.

Adult↗

Treatment with secretin and a cholecystokinin-like peptide in patients with pancreatic cancer. A pilot study.

Secretin and cholecystokinin (CCK) have trophic effects on the pancreas and may therefore have a place in the treatment of pancreatic cancer. The present study was performed to examine whether these hormones may cause harm in patients with pancreatic cancer receiving cytostatics. The cytostatics were 5-fluorouracil, adriamycin, and mitomycin C(FAM). Secretin plus Thr28Nle31CCK25-33, in doses stimulating pancreatic secretion to about 60% of maximal, were given as a continuous 6-day intravenous infusion just before (four patients) or immediately after (five patients) starting treatment with FAM. Five patients received FAM only. When considering symptoms, laboratory findings, abdominal CT scans, and survival, no evidence was found that secretin and CCK may cause serious or unpleasant side effects in patients with pancreatic cancer receiving cytostatics.

Adenocarcinoma↗

Prophylactic regimens in colorectal surgery. Comparison between metronidazole used alone or in combination with either ampicillin or doxycycline.

Sixteen hospitals are participating in this study, that started in October 1982 and will be concluded when 456 patients have been admitted. The study includes patients eligible for elective colorectal surgery. Inclusion criteria, surgical techniques, definition of recognizable infection, sampling of specimens for bacteriological investigations, bacteriologic techniques, and evaluation criteria were standardized. Patients were divided into 2 main groups. Patients in Group 1 received either a single intravenous dose of 1500 mg metronidazole or this dose was combined with a single, intravenous dose of 6 g ampicillin. Patients in group 2 received either a single intravenous dose of 1500 mg metronidazole or this dose combined with a single intravenous dose of 400 mg doxycycline. Dosage regimens were allocated randomly. The current results concern 136 patients. Postoperative infections were seen in 6.7% of the patients receiving metronidazole alone, and 2.9% of the patients receiving metronidazole + ampicillin (Group 1). In Group 2, postoperative infection occurred in 17.1% of the patients receiving metronidazole alone, and in 2.7% of those receiving metronidazole + doxycycline.

Adult↗

[Trampoline therapy with brain-injured children and adolescents (author's transl)].

Trampoline therapy is a useful part of the medical rehabilitation treatment of brain-injured children and adolescents, if the basic principles of accident prevention are observed. The therapy should only consist of systematically organised exercise series and be carried out by adequately trained sport teachers, medical paedagogues or physical therapists. In the "Jugendwerk Gailingen" an improvement of the standing balance and movement co-ordination was achieved in more than 20 patients with hemiparesis and tetraparesis. Only little progress was achieved in atactic and athetoid patients. It is important to stress the positive psychological effects of the trampoline therapy.

Adolescent↗