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Biomedical subjects

H Goebell

Publications and source records attributed to H Goebell.

At least 253 records · Page 14Linked to original sources
PubMed1981

[Neurofibroma of the small bowel in Recklinghausen's disease as a rare cause of chronic intestinal bleeding (author's transl)].

A case report is given of a 66 year old woman with Recklinghausen's disease, suffering from chronic gastrointestinal bleeding as a rare complication of enteric neurofibromatosis. Localization could be established only by angiography. After resection of the tumor with an ulceration at its tip hemorrhage stopped. The incidence of gastrointestinal neurofibromatosis, as well as its symptoms, diagnosis and treatment are discussed.

Adult↗
PubMed1981

Pharmacological actions of calcitonin on the gastrointestinal tract and their therapeutical implications.

The role of calcitonin (CT) in the regulation of the calcium homeostasis in humans is doubtful, while the therapeutic use in various bone diseases gains increasing interest. Numerous investigations during the last eight years have indicated that CT affects a variety of gastrointestinal organs when CT is administered in pharmacological high doses: CT inhibits gastric acid and pepsin secretion, gastrin release, pancreatic enzyme secretion as well as the hormonally stimulated contraction of the lower esophageal sphincter and of the gallbladder. CT increases intestinal secretion. The therapeutic use of CT in gastric hypersecretory states appears to be inferior and less practicable compared to the histamine-H2-receptor antagonists. The benefit of CT in the clinical course of acute pancreatitis was observed in two controlled double blind studies but CT did not lower the mortality rate. CT does not influence increases in serum-amylase and -lipase occurring after ERCP.

Acute Disease↗
PubMed1981

[Excretion of lead in the gastric and duodenal juice of persons with occupational lead poisoning and normal subjects].

Lead was measured in the gastric and duodenal juice of three patients with lead poisoning (blood concentrations of lead: 4.30; 5.16; 5.50 mumol/l). The lead excretion into the gastric juice was 94.6; 29.9 and 18.3 nmol Pb X h-1 for the poisoned persons and 57.9 +/- 38.1 nmol Pb X h-1 for healthy persons (n = 20). Pentagastrin (6 microgram/kg, i.m.) stimulated lead excretion in both groups (normal + 109%, lead poisoned persons: + 180%; + 187%; + 311%). The lead excretion was correlated with an increase of HCl-secretion and volume in healthy persons. The lead excretion into the duodenal juice after secretion (1 unit/kg) amounted to 14.2 +/- 8.8 nmol Ph X h-1 in healthy persons, whereas after secretion plus caerulein 18.8 +/- 7.2 nmol Pb X h-1 were found. In the duodenal juice of the lead poisoned persons 27.5 and 474.9 nmol Ph X h-1 respec. were found after secretion and 58.9 and 491.8 nmol Pb X h-1 respec. after secretion plus caerulein. Lead excretion was correlated with enzyme secretion (trypsin and chymotrypsin).

Ceruletide↗
PubMed1981

[The frequency of gallstones in liver cirrhosis (author's transl)].

Out of 11 840 autopsies from 1940-1975 697 cases with cirrhosis of the liver were found. The percentages of gallstone disease in these cases was analyzed as compared to non - cirrhotic controls. 21,5% of cirrhotic patients had cholelithiasis versus 16,5% in the controls (p less than 0,001). In women 35,2% of cirrhotics versus 26,3% (p less than 0,01) and in men 16,2% versus 10,8% (p less than 0,001) were found with gallstones. Including cases with cholecystectomies the frequencies was 22,8% for cirrhosis and 19,9% for controls (men 16,9% versus 12,9%, women 37,7% versus 33,6%). These differences were not significant. The female to male ratio for the frequency of cholelithiasis was found to be 2,2 : 1 and was not altered as compared to be controls. In cirrhotic and control patients the frequency of cholelithiasis increased steadily with each decade of age, again more in women than in men. A tendency to higher frequencies for gallstones in cirrhotic patients was found from the 5th decade onwards, but this was not statistically significant.

Adult↗
PubMed1980

Inhibition of human gastric secretion by intragastrically administered calcitonin.

The effects of intragastrically administered synthetic human calcitonin (H-CT) and salmon calcitonin (S-CT) on human gastric secretion have been compared with the effects of both CTs after intravenous infusion. Basal as well as pentagastrin-stimulated acid and pepsin output were lowered by about 50% in response to a single intragastric instillation of H-CT while an intravenous infusion of H-CT produced an inhibition of more than 70%. After intragastric instillation, dose-response curves of H-CT and S-CT were in a similar range when the dose was referred to the molarity of CT; however, related to the biological activity of CT (MRC units), S-CT was about 10--15 times less effective than H-CT. Conversely, after intravenous infusion, equal doses in reference to MRC units evoked similar responses while in reference to molarity S-CT was 20--30 times more effective than H-CT. Radioimmunological determinations of H-CT showed after intragastric instillation a stepwise decrease in concentration of H-CT in the gastric juice and no appearance of H-CT in the blood. In contrast, after intravenous administration of H-CT, no detectable H-CT activity was secreted into the juice in the presence of a peak increase in serum-immunoreactive H-CT. From the differences in the effects of CT observed after intragastric and intravenous administration, respectively, it is suggested that intragastrically administered CT might inhibit gastric secretion via local mechanisms on the gastric mucosa.

Adult↗
PubMed1980

Immunoreactive secretin release following taurocholate perfusions of the cat duodenum.

Perfusion of the cat duodenum with sodium taurocholate (TC), 120 mmol/l, at pH 6.1 increased the plasma immunoreactive (IRS) concentration from 2.2 +/- 0.7 pmol/l to 29 +/- 6.1 pmol/l during the first 20 min. This was accompanied by an increased pancreatic secretion of fluid, while the chymotrypsin output showed a "wash-out' phenomenon. TC increased both the bile-acid-dependent and the bile-acid-independent bile secretion. In comparison, HCl, 150 mmol/l, increased IRS from 0.9 +/- 0.5 pmol/l to 41 +/- 15 pmol/l, producing an increase in the pancreatic fluid secretion. However, only a slight increase in the bile-acid-independent bile secretion was found, and the bile-acid-dependent secretion did not change. The effects of TC on the pancreatic secretion were produced at concentrations occurring in cat hepatic bile.

Animals↗
PubMed1980

Stimulation of bile and pancreatic secretion by duodenal perfusion with Na-taurocholate in the cat compared with jejunal and ileal perfusion.

In the anesthetized cat duodenal perfusion with Na-taurocholate (TC, 0.2 M, pH 6.1, 290 mosmol, 45 ml x h-1) stimulated pancreatic volume (0 to 326 +/- 236 mg x 10 min-1) and bicarbonate secretion (0 to 34.2 +/- 4.1 mumol x 10 min-1), whereas pancreatic enzyme output was sparse. Simultaneously with the pancreatic response, bile flow increased from 139 +/- 74 mg to 484 +/- 146 mg x 15 min-1 (p < 0.05). During perfusion of the upper jejunum both pancreatic and biliary responses were significantly lower than the responses to duodenal TC perfusion (p < 0.05). During TC perfusion of the terminal ileum there was no response from the pancreas, whereas the increase in bile flow accounted only for an increase in the bile-acid-dependent fraction. The concomitant stimulation of both the hydrokinetic function of the pancreas and the bile-acid-independent bile flow might be mediated by a release of secretin.

Animals↗
PubMed1980

[The pathophysiology of acute pancreatitis (author's transl)].

An acute pancreatitis is possible, both in a hitherto healthy organ (mainly together with gallstones) and in a chronically danaged gland (maily together with alcoholism). Toxic damage of the pancreas is found in hypercalcemic states and with drugs. It is unknown what directly induces acute inflammation in the pancreas. The pathophysiological consequences of acute pancreatitis are mainly volume deficiency and shock, renal failure, pulmonary insufficiency, disturbances of carbohydrate metabolism and blood clotting. Prognosis of acute pancreatitis is difficult to evaluate. Clinical findings and laboratory parameters are utilized together to judge the presumable course of the disease.

Acute Disease↗
PubMed1980

Light and electron microscopy of human liver before and during chenodeoxycholic acid therapy.

Thirteen patients (9 women, 4 men) with solitary (7) or multiple (6) radiolucent gallstones were treated with 1.0 g/day CDCA over a period of 7--17 months (mean 10.2). Routine liver function tests showed no changes compared to pre-treatment values, except a moderate elevation of SGPT activity in one patient. Serum cholesterol and serum triglyceride levels remained unchanged during therapy. 21 liver biopsies in 11 patients compared to pre-treatment controls studied by light and electron microscopy revealed no lesions in hepatic structure, especially no signs of cholestasis. Only some unspecific changes in liver ultrastructure as shown during therapy with other drugs developed during CDCA treatment (lipofuscin depositions, swollen and condensed mitochondria and a dilated rough endoplasmic reticulum). It is, therefore, concluded that CDCA therapy for gallstone dissolution has no hepatotoxic side effects.

Adult↗
PubMed1980

[Eosinophilia as a diagnostic clue to primary sclerosing cholangitis (author's transl)].

The history of a 38-year-old, asymptomatic man with primary sclerosing cholangitis is reported. The diagnosis has been suggested by eosinophilia (66%, 27 X 10(9)/l leucocytes) and markedly elevated serum alkaline phosphatase levels (1860 U/l) and has been established by endoscopic retrograde cholangiography. Report of a therapeutic approach with D-Penicillamin. Documentation of follow-up by endoscopic retrograde cholangiography.

Adult↗
PubMed1980

Hypercaloric nutrition as aetiological factor in chronic pancreatitis.

Nutritional habits were evaluated in 31 patients with confirmed chronic calcifying pancreatitis (CCP) (n = 11, mean age 43,9 years) and chronic non-calcified pancreatitis (CP) (n = 20, mean age 44,5 years). Each patient was matched with two healthy persons of same age, sex and social class. In the patients with CCP before onset of the clinical disease the daily intake of fat (156 g versus 89 g), of carbohydrates (325 g versus 262 g, of alcohol (124 g versus 19 g) and of total calories (4110 versus 2250) was significantly higher than in the control persons. In the patients with CP likewise the daily intake of fat, alcohol and total calories (3598 versus 2069) was significantly higher than in the controls. After onset of the clinical signs of pancreatitis, the intake of nutrients was significantly reduced, mainly due to a lower intake of fat and alcohol.

Adult↗
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↗