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Biomedical subjects

H G Rohner

Publications and source records attributed to H G Rohner.

At least 37 records · Page 2Linked to original sources
PubMed1984

Primary malignant melanoma of the oesophagus.

Primary malignant melanoma of the oesophagus is a rare tumour, whereas metastatic disease originating from melanomas is occasionally encountered in the upper GI-tract. Two cases of endoscopically diagnosed primary esophageal melanomas are presented which were treated by surgery and radiotherapy combined with immunostimulation, respectively.

Aged↗
PubMed1984

[2 or 4 daily doses of cimetidine in the treatment of gastric ulcer?].

In a randomized multicentre study of 149 patients with gastric ulcer the effect of 1000 mg cimetidine daily applied in four separate doses was compared to that of 400 mg cimetidine twice a day. In both patient groups similar healing rates were observed. 80.3% and 74.0%, respectively, of the ulcers healed within 6 weeks, and 93.8% and 90.3%, respectively, within 10 weeks. Abdominal pain and antacid consumption decreased under both regimens to a similar degree. Drug safety was good. Lower cost and simplicity in the administration make the b. i. d. regimen of cimetidine preferable to the q. i. d. regimen in the acute treatment of gastric ulcer.

Alcohol Drinking↗
PubMed1984

[Primary malignant melanoma of the esophagus].

Two case reports are given of patients suffering from malignant melanoma of the esophagus, which occurs very rarely. In both patients the leading clinical symptom was dysphagia. Diagnosis was confirmed by endoscopy and biopsy, and surgery was done. One patient died within 3 weeks from pneumonia, the second patient is alive 3 months after resection of the tumor and is free of symptoms.

Aged↗
PubMed1983

[Surgical treatment of ulcer disease 5 years before and after the introduction of cimetidine].

To determine whether H2-antagonists have changed type and frequency of operations for peptic ulcer, all operations of the one hospital of a city with a population of 80 000 were analysed. The total number of operated patients decreased after cimetidine from 425 to 278 (35%). The ratio of male to female patients was 3:1 in either period. While the decrease in elective operations of uncomplicated ulcer was 51%, operations in patients with ulcer complications (bleeding, perforation, stenosis) decreased by only 9%. The decrease was above average in Billroth I and Billroth II gastrectomy, but the number of patients with selective vagotomy increased 3-fold. The number of operations decreased by 40% for duodenal ulcer and by 20% for gastric ulcer. Of all ulcer complications bleeding decreased by 31%, the number of perforations was unchanged, but the number of patients with stenosis increased by 58%. Overall mortality decreased from 25 in the initial to 20 in the subsequent five year period. Twenty and 19 patients, respectively, died with complicated ulcer disease (12,5% of all operations), mortality was 6 (1,5%) with operations for uncomplicated ulcer.

Cimetidine↗
PubMed1982

[Treatment failure of cimetidine in duodenal ulcer (author's transl)].

Acid secretion was measured after a six-week standard treatment with cimetidine in ten patients each with healed or non-healed duodenal ulcer, and the drug's pharmacokinetics studied. There was no difference between the two groups with respect to fasting concentration of cimetidine (compliance), the area under the plasma-level curve, as well as renal excretion (bioavailability) and the period of effective plasma concentration. Maximal secretion during cimetidine treatment was also identical in the two groups. On the other hand, basal secretion in the group of treatment failure was significantly increased (P less than 0.05). Basal secretion during administration of cimetidine can be used as a prognostic criterion for the healing of duodenal ulcer.

Biological Availability↗
PubMed1982

Gastric acid inhibition and oxmetidine kinetics in duodenal ulcer.

Gastric acid inhibitory effects and kinetics of oxmetidine, a new histamine H2-receptor antagonist, were examined in five patients with duodenal ulcer disease. A constant intravenous infusion of impromidine was used to stimulate gastric acid secretion for 6 hr. Oxmetidine was then given in a 28-mg IV infusion and a 200-mg oral solution. The maximum inhibition of gastric acid output was, on average, 77% after infusion and 92% after oral doses, with similar values for volume inhibition. Mean overall percent inhibition of acid output, volume, and H+ concentration was 22%, 8%, and 15% for the intravenous dose and 51%, 33%, and 29% for the oral dose. The effect lasted for 3 hr after the intravenous dose and for 5 hr after the oral dose. Mean values for systemic clearance and half-life were 161 ml/min and 2.3 hr. An average of 4.3% of the dose was recovered in urine as unchanged drug and 27% was recovered as a glucuronide metabolite. Mean bioavailability was 36%. Plasma concentration for 50% inhibition of acid output was 0.50 microgram/ml, indicating that oxmetidine is 2.5 times as potent as cimetidine. No adverse effects were noted during the study.

Adult↗
PubMed1982

Effect of smoking on duodenal ulcer healing with cimetidine and oxmetidine.

The effect of oxmetidine 800 mg/day, a new histamine H2-receptor antagonist, on duodenal ulcer healing was compared with cimetidine 1000 mg/day in a two-centre double-blind trial. Ninety-nine patients completed the study. After four weeks, ulcers were healed in 74% of the cimetidine-treated patients and in 78% of the oxmetidine-treated patients (p greater than 0.05). Healing rates after eight weeks increased to 90% in the cimetidine group and to 94% in the oxmetidine group. Healing rates after four weeks were, however, different in the two centres (p less than 0.01): in centre 1 88% of the cimetidine-treated, but 63% of the oxmetidine-treated patients healed, in centre 2 rates were 60% (cimetidine) and 92% (oxmetidine). Analysis of patient data revealed that in the two centres treatment success was inversely correlated (p less than 0.01) with the percentage of smokers in each treatment group. Smoking significantly influences duodenal ulcer healing with histamine H2-receptor antagonists.

Adult↗
PubMed1982

Salivary secretion in reflux esophagitis.

It has been speculated that impaired salivary flow and contents contribute to abnormal acid clearance in patients with reflux esophagitis. To test this hypothesis, salivary secretion of volume, bicarbonate, and N-acetylneuraminic acid was measured in patients with reflux esophagitis, in age- and sex-matched controls, and in healthy young volunteers. Resting saliva was collected by permitting the saliva to drip into a flask every 30 s. Parotid saliva was collected by means of a Lashley capsule during stimulation by oral infusion of 1 ml/min of 2% citric acid. Total mixed saliva was collected by a dental sucker during esophageal perfusion with water and 10-mM hydrochloric acid. The volume of resting saliva and its concentration of bicarbonate were similar in the three groups. The concentration and the output of N-acetylneuraminic acid were higher in the young volunteers than in the two other groups. The volume flow and the composition of stimulated parotid saliva were similar in the three groups of subjects. Volume of total mixed saliva and concentration of bicarbonate and N-acetylneuraminic acid during esophageal perfusion with water were higher in patients with reflux esophagitis than in age- and sex-matched controls and were similar to the values found in young healthy volunteers. Acid perfusion increased the secreted volume of total mixed saliva by 150% and the concentration of bicarbonate by 30% in healthy young volunteers, but not in patients with reflux esophagitis and in the healthy age- and sex-matched controls; the concentration of N-acetylneuraminic acid was left unaffected by acid perfusion in all three groups. These findings disprove the hypothesis of impaired salivation in reflux esophagitis. The age-related loss of salivary response to acidic esophageal perfusion might be the reason why reflux esophagitis with peptic lesions affects predominantly elder people.

Adult↗
PubMed1982

[Skin and bone findings in mastocytosis].

The syndrome of mastocytosis extends from cutaneous urticaria pigmentosa through systemic mastocytosis to the rarely occurring mast cell leukaemia. Our investigations with a large patient collective have shown that systemic forms of the disease occur more often than is generally supposed. In particular the incidence of bone marrow manifestations deserve more attention. The inflammatory-granulomatous findings in the bone marrow suggest an immunoactive component in the pathogenesis of this disease. The bone lesions that occur in about 50% of patients are probably the result of the common endosteal site of the mastocytosis granuloma. These lesions can be generalized (osteoporosis-osteosclerosis) or localized (osteolytic-osteosclerotic foci). In clinical practice bone biopsy and skeletal radiology complement one another; in addition to skin biopsy bone biopsy supplies the initial diagnosis of mastocytosis and documents systemic manifestation; the X-ray picture informs the clinician about the type and extent of the bone pathology.

Adolescent↗
PubMed1982

Clomethiazol tablets induce ulcers in the esophoagus.

A 55 year old woman developed severe retrosternal pain and odynophagia four hours after taking a tablet of clomethiazol. Endoscopy revealed extensive ulceration of the upper esophagus 19-23 cm from the incisors. Esophageal manometry showed reduced contraction amplitudes in this area. The lesions healed rapidly after the medication was stopped, and the motility disturbances of the esophagus improved. Thus, clomethiazol tablets have to be included in the list of drugs which can damage the esophageal mucosa. This damage is probably due to the acid salt ethanedisulfonate of the clomethiazol tablets. Clomethiazol capsules are preferable since they do not appear to be harmful to the esophagus.

Acute Disease↗
PubMed1982

[Tuberculous stenosis of the duodenum].

A 51-year-old man came to hospital admission one year after the first occurrence of upper abdominal pain, nausea, fever, melaena and discrete symptoms of inflammatory disease, X-ray examination of the chest, colon and ileum were normal. Sonography and computertomographic examination showed a mass in the pancreatic head region. Diagnosis was established by endoscopy and examination of bioptic material, showing ulcerating and stenosing tuberculosis of the duodenum with caseating, tuberculoid granuloma and acid stabile bacilli. Tubercle bacilli of the human type could be demonstrated in bacterial culture. Granuloma of epitheloid cells could also be found in the liver. Drug therapy with tuberculostatic drugs brought about complete healing of the macroscopical lesions within 4 weeks. In patients with stenosing processes of the duodenum tuberculosis should also be taken into account as a rare cause of this condition.

Biopsy↗
PubMed1981

[Mastocytosis and the gastrointestinal tract].

Gastrointestinal symptoms frequently occur in patients with systemic mastocytosis. The gastrointestinal tract, liver, and spleen may be involved in this disease. In addition to investigations of our own in patients with mastocytosis, gastroenterologica manifestations from the literature are reviewed.

Digestive System↗
PubMed1980

[Effectiveness of proxyphylline in chronic obstructive pulmonary disease (author's transl)].

The bronchospasmolytic action of proxyphylline given intravenously in a dosage of 16 mg/kg body weight was assessed by spirometry and bodyplethysmography in 12 patients with chronic obstructive pulmonary disease. Proxyphylline serum levels were estimated in parallel repeatedly. In the majority of patients a bronchospasmolytic effect could be established (lowering of airway resistance by 30% in 9 and by 40% in 7 patients). In some an action was demonstrated for up to 4 hours. There were no serious side effects and in particular no adverse cardiovascular reactions or skeletal muscular tremor.

Adult↗