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Biomedical subjects

H Goebell

Publications and source records attributed to H Goebell.

At least 19 recordsLinked to original sources
PubMed1979

Similar modes of action of calcitonin and glucagon in inhibiting pancreatic enzyme secretion in man.

The inhibitory action of both calcitonin (CT) and glucagon (GK) on human pancreatic secretion has been evaluated in detail. The reduction of enzyme secretion expressed as percentage corresponded to 60--80% of the initial values in response to both CT and GK when the hormones were given as single infusions during background stimulation with secretin or with secretin plus cholecystokinin-pancreozymin (CCK-PZ). After withdrawal of GK-infusion the return to normal values of enzyme secretion was distinctly faster than after CT, thus reflecting a more rapid degradation of circulating GK than of CT. In the presence of stimulation with secretin plus CCK-PZ, the combined administration of CT and GK did not enhance the inhibitory actions of CT and GK. Fluid and bicarbonate secretions were not affected by either CT or GK. The results suggest that CT and GK inhibit human pancreatic enzyme secretion by similar modes of action. Therefore, the combined administration of both CT and GK does not offer a reasonable approach to the treatment of acute pancreatitis.

Adult↗
PubMed1979

A double-blind trial of synthetic salmon calcitonin in the treatment of acute pancreatitis.

A multicenter randomized double-blind trial on the use of synthetic salmon calcitonin (SCT) was carried out in 94 patients with acute pancreatitis. In addition to strict standard treatment--without aprotinin, atropine, or antacids--50 patients received daily 3 x 20 micrograms = 300 MRCU SCT intravenously and 44 patients received placebo for 6 days. Mortality rate was not influenced, overall mortality being 5.3%. The number of patients without pain and with normalized serum amylase on a given day was significantly higher in the group treated with SCT. Other parameters such as doses of analgesics, leukocyte count, and normalization of seven defined clinical and laboratory criteria within 6 days showed a positive trend without reaching significance.

Acute Disease↗
PubMed1979

[The conservative treatment of acute pancreatitis in the Federal Republic of Germany in 1977 (author's transl)].

A questionnaire on the conservative treatment of acute pancreatitis was answered by 312 surgical [n = 139] and medical [n = 173] departments from all over Western Germany and from West-Berlin. Nearly total positive agreement was found about routine administration of parenteral fluids and on the prohibition of oral food and fluids. The application of glucocorticoids, glucagon, heparin in small doses and of a carboanhydrase inhibitor [Diamox] is rejected by most of the departments. Renal failure is treated in 63% by hemodialysis and in 37% by peritoneal dialysis. There is great disagreement between the answers about the administration of atropine, antacids and aprotinin [Trasylol]. Antibiotics are applied routinely by 63% of the surgical and 70% of the medical departments.

Acute Disease↗
PubMed1978

[Absorption in the human small intestine relative to the intraluminal milieu].

The bulk of water and electrolyte absorption takes place in the human jejunum from isotonic solutions, and is determined largely by special transport mechanisms for different monosaccharides, amino acids and dipeptides. This is of considerable significance for regaining the large volumes of fluid delivered to the small intestine during the digestion of food. Small changes in intraluminal pH do not significantly influence the absorptive function of the jejunum and are rapidly compensated by the buffering capacity of the gut. The maintenance of an isotonic as well as neutral intraluminal milieu seems to be essential to the physiological processes of intestinal absorption.

Diarrhea↗
PubMed1978

Interactions of calcium, magnesium and atropine on exocrine pancreatic secretion in man.

The effects of the intravenous administration of atropine or magnesium on pancreatic secretion which has been stimulated by secretin and induced hypercalcaemia have been studied in man. In the presence of secretin (0.5 CU/kg.h) the infusion of Ca2+ (0.3 mmol/kg.105 min) resulted in an increase in secretion of enzymes by 100-200%, and in that of Ca2+ and Mg2+ by 50-100% without affecting fluid and bicarbonate secretion. The additional injection of atropine (0.5 mg i.v. and 0.5 mg s.c.) were followed by a prompt fall in enzymes but not in Ca2+ and Mg2+ to the secretin-stimulated values. The additional infusion of Mg2+ (0.12 mmol/kg.45 min) to the Ca2+-infusion did not alter the secretion of enzymes, Ca2+ or Mg2+ compared with the calcium infusion alone. It is suggested that the hypercalcaemic stimulus depends on an intact innervation of the acinar cells. In these experiments the secretion of Ca2+ and Mg2+ seem to originate mainly from extracellular fluxes.

Adolescent↗
PubMed1978

[Effect of alcohol on the human and animal pancreas (author's transl)].

In Germany alcohol is responsible for 40--60 per cent of cases with chronic or chronic relapsing pancreatitis. The histologic lesions for a long time remain clinically asymptomatic. Their degree depends on the duration and the total amount of alcohol which is ingested. Promoters of alcoholic damage to the pancraes are a high intake of fat and protein and a genetic disposition. Acute application of alcohol leads to an inhibition of pancreatic secretion when the entrance of gastric acid into the duodenum is prevented. Otherwise a weak stimulation occurs with release of secretin. Chronic application of alcohol after a few months abolishes the initially seen inhibition and leads to an increase of enzyme secretion of the gland. The raised concentration of protein in the pancreatic juice is the cause of precipitation of protein plugs, and thus probably leads to the alterations which are typical for chronic pancreatitis.

Alcoholism↗
PubMed1978

[Gastric and exocrine pancreatic function in patients with medullary thyroid carcinoma and with bone diseases under treatment with calcitonin (author's transl)].

Calcitonin (CT) inhibits gastric acid and pancreatic enzyme secretion when infused intravenously. Therefore, in two patients showing excessively elevated CT-blood levels due to medullary thyroid carcinoma and in two patients with bone diseases before and under CT-treatment, gastric and pancreatic secretion were measured. Spontaneous (BAO) and pentagastrin stimulated acid as well as hormonally stimulated pancreatic enzyme secretion revealed normal in all subjects and tests. The findings are in favour of adaptation mechanisms of gastric parietal and pancreatic acinar cells against the inhibitory action of chronically elevated CT. Therefore, long term treatment with CT is no likely to induce impaired acidity or exocrine pancreatic insufficiency.

Adaptation, Physiological↗
PubMed1977

Treatment of acute viral hepatitis with (+)-cyanidanol-3.

A double-blind trial of (+)-cyanidanol-3 (2 g/day) versus placebo tablets was carried out in 100 patients with acute viral hepatitis. 51 received the drug and 49 placebo. (+)-Cyanidanol-3 accelerated the disappearance of HBsAg from the blood, lowered serum-bilirubin, and relieved symptoms such as anorexia, nausea, and pruritus. The drug was well tolerated. None of the patients had a relapse of acute hepatitis. Chronic active hepatitis developed in 1 of the placebo-treated patients. Thus, (+)-cyanidanol-3 seems to be of benefit in acute viral hepatitis.

Adult↗
PubMed1977

Calcitonin and exocrine pancreatic secretion in man: inhibition of enzymes stimulated by CCK-pancreozymin, caerulein, or calcium--no response to vagal stimulation.

The effect of calcitonin on human pancreatic secretion was studied under various conditions of stimulation. During administration of both secretin plus cholecystokinin-pancreozymin (CCK-PZ) or secretin plus caerulein, enzyme secretion was promptly reduced by an infusion of calcitonin of more than 50%. In contrast, vagally stimulated enzyme secretion induced by insulin-hypoglycaemia or carbamyl-choline was not altered against a background infusion of calcitonin in comparison with control experiments. Calcium-induced enzyme secretion was abolished by additional calcitonin infusion which also prevented an increase in serum calcium. On the other hand, additional high grade calcium infusion did not modify the inhibitory action of calcitonin on enzyme output stimulated by secretin and CCK-PZ. Secretion of fluids and bicarbonate remained unaffected by calcitonin in all experimental conditions, whereas the outputs of calcium and magnesium paralleled generally the changes in enzymes. It is suggested that calcitonin interferes with hormonemediated stimulation of the acinar cells without influencing cholinergic mechanisms. The inhibitory action of calcitonin on enzyme secretion does not appear to be mediated by a depletion of extracellular calcium in the pancreatic tissue by calcitonin.

Adult↗
PubMed1977

Massive pancreatic ascites without carcinoma. Report of three cases.

Three cases of benign pancreatic ascites have been added to 94 cases reviewed from the literature. Common characteristic of this syndrome were chronic alcoholism, intermittent abdominal pain, nausea, vomiting and considerable weight loss which occurred despite fluid accumulation. Markedly elevated protein and amylase levels in the ascitic fluid, hyperamylasemia and hypoalbuminemia were the major diagnostic clues as to the pancreatic origin of ascites. Predominant pathological findings were chronic pancreatitis with or without pseudocysts, pancreatic duct disruption, lesion which were considered to be the major pathogenic factor besides lymphatic obstruction by leaking pancreatic juice into the peritoneal cavity. Early laparotomy for diagnosis and treatment is essential. ERP might be of great value in diagnosis.

Adult↗