[The 13C-urea breath test in Helicobacter pylori colonization of the gastric mucosa].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to H J Wildgrube.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The purpose of this study was to optimize the cleaning for colonoscopy. We compared a combination of senna pods and Goleytely solution to the exclusive ingestion of 7 litres of Goleytely solution. Test parameters were the score of visual assessment in five regions of the large bowel, the distension of the abdomen, concentration of hydrogen and methane in intestinal gases and subjective informations about abdominal complaints. We concluded from 80 colonoscopies that the combined procedure was almost identical with the cleaning by voluminal ingestions of Goleytely solution. There were no differences in the scores of visual assessment or concerning the intestinal gases. The additional administration of simethicone resulted in a statistically significant decrease of foam production. Thus, the combination of senna pods, a reduced ingestion of Goleytely solution supplemented with simethicone can be recommended for colonoscopy.
The characteristics of the echo structure constitute an important criterion for the appraisal of sonograms. Since every pixel usually represents one out of 64 gray values, it should be possible to use the density as an objective parameter of the echo structure. In this study, the echogenicity of the pancreas was examined. The density of the pancreas became higher with increasing accumulation of fatty connective tissue or as a result of air in the intestine. In 42 people with varying degrees of obesity, the echo structure was compared with the gray scale distribution of the lumen of the gallbladder, aorta and the water-filled stomach. The results indicated that the increasing echodensity is attributable to reflections and scatter of the ultrasound in adjacent regions. The presence of air gave rise to the same effect. On the basis of standardized investigations at 15-minute intervals, the density and the visual index under the influence of a quick-acting simethicone preparation (Lefax) were compared. The density also decreased significantly within 30 to 45 minutes parallel to the reduction of superimpositional interferences due to air. The present investigations confirm the relevance of gray scale analysis for objective confirmation of sonographic structures. However, they make it evident that the echo pattern is quantifiable only under standardized conditions and when the projection plane is largely occupied. Misleading mixed values are measured in marginal zones and in superimpositions.
Explore the source record for details and available documents.
The aim of this study was to determine the biliary pattern of conjugated bile acids after stimulation of their enterohepatic circulation. Conjugated bile acids were separated by reversed-phase ion-pair chromatography without prior derivatization. A MicroPak SP-C18-IP-4 column was used as non-polar matrix, and an ionic alkyl compound, tetrabutylammonium phosphate, was added to the mobile phase, which was a mixture of acetonitrile and water. Quantification was made by UV absorption at 210 nm with external standardization. In fourteen human patients with external biliary drainage after papillotomy there was preferential glycine conjugation. The mean values were 36.5% for glycocholic acid, 33% for glycochenodeoxycholic acid, and 10.0% for glycodeoxycholic acid. Only 15.2% of the biliary bile acids were taurine metabolites. Conjugates of ursodeoxycholic acid were below 2.1%. In most cases, conjugated lithocholic acid was not detected. Within 4 h after ingestion of a standardized meal there were no significant changes in the biliary bile acid pattern. In four dogs (beagles), glycine-conjugated bile acids were lacking. The mean values were 74.3% for taurocholic acid, 14.9% for taurodeoxycholic acid, and 5.3% for taurochenodeoxycholic acid. In six rabbits, 87.4% of biliary bile acids was identified as glycodeoxycholic acid and 5.3% as glycocholic acid. In conscious dogs, as well as in rabbits, the stimulation of biliary secretion by cholecystokinin and/or secretin had no effect on the biliary bile acid spectrum. Evidently, there is a difference in the biliary composition of conjugated bile acids between humans, dogs, and rabbits. Because of the different physicochemical behaviour of glycine- and taurine-conjugated bile salts, it seems difficult to compare the therapeutic effect of gallstone dissolution in various species.
Plasma levels of N-carboxy-3-morpholinosydnonimine ethyl ester (molsidomine, Corvaton) and its pharmacologically active metabolite 3-morpholinosydnonimine (SIN-1) were measured in six healthy male and female volunteers after single intravenous and oral dosing of 4 mg molsidomine. Additionally indocyanine green and phenazone (antipyrine) clearances were determined to estimate hepatic blood flow and metabolic liver function in each subject. The pharmacokinetic parameters of molsidomine were similar to already published data in healthy volunteers and patients. The plasma level of SIN-1 formed was always lower than the molsidomine level but obviously reflects the corresponding molsidomine concentration time course in plasma. Indocyanine green plasma clearance was reduced by 15%. after intravenous dosing of 4 mg molsidomine. There was no clear-cut relationship between the plasma clearances of molsidomine and phenazone in these subjects with normal metabolic liver function.
Explore the source record for details and available documents.
The efficacy of the hepatitis B vaccine Hevac B Pasteur was assessed in 277 persons over a period of 6 months. HBs antigen of 5 micrograms/dose was administered three times in monthly intervals. Before each vaccination and after 6 months 18 chemical pathology data and a clinical assessment were performed and all important serologic hepatitis markers (anti-HBs, anti-HBc, HBs antigen, HBc antigen, anti-HBe) were determined radioimmunologically. Within two months antibodies against the surface antigen (anti-HBs) had developed in 85.7% of vaccinees. After 6 months 93.1% of vaccines had become seropositive. Within the first two months anti-HBs-positive findings and higher anti-HBs concentrations occurred significantly more frequently (P less than 0.048) in females than in males. These differences had largely disappeared at the follow-up assessment in the sixth month. In contrast, both parameters (seroconversion rate and anti-HBs concentration) were age-dependent. Among vaccines of less than 25 years of age and of more than 35 there were significant differences after 6 months (P less than 0.005). The hepatitis B vaccine of the Pasteur institute can be considered immunogenic and safe.
HBs antigen, anti HBs and anti HBc were determined radioimmunologically on 314 medical students, 585 doctors, 151 medical laboratory personnel and 307 nursing staff. Hepatitis B markers were present in 5.1% of medical students, 23.4% of doctors, 17.9% of laboratory personnel and 18.6% nursing staff. In the different groups there were up to 1.3% HBs antigen-positive persons. A large majority of persons with signs of previous hepatitis B infection had concentrations of both antibodies (anti-HBs and anti-HBc). Between 0.6 and 5.5% of persons were merely anti-HBc positive. Among doctors the number of positive results increased with age and professional exposure, no age dependence as to seropositive or seronegative being found in the other groups. None of the persons tested had been aware of a preceding hepatitis infection. These results indicate that doctors and medical personnel even today are at risk of an undetected viral hepatitis B.
Vhe quantitatively most important conjugated bile acids in man were separated by reversed-phase ion-pair chromatography without prior derivatization. As non-polar matrix an Ultrasphere I.P. column (C18) was used, and an ionic alkyl compound, tetrabutylammonium phosphate, was added to the mobile phase, which was a mixture of acetonitrile and water. Under these conditions, the glycine and taurine conjugates of cholic acid, chenodeoxycholic acid and deoxycholic acid were separated within 15 min. At 214 nm, the minimum measurable concentration was 1.3-2.0 nmol/ml. The average recovery from bile was 94%. In ten patients with biliary drainage an average of 79.5% of the bile acids were glycine conjugates.
Explore the source record for details and available documents.
In 12 patients with Laennec's cirrhosis conjugated cholic acid was measured by radioimmunoassay simultaneously in the portal vein, the aorta, and the hepatic vein. Furthermore, the concentration was measured for 90 minutes after i. v. injection of cholecystokinin. In the fasting patient the porto-venous extraction ratio was 0.45 (SD 0.23) and the arterio-venous extraction ratio was 0.24 (SD 0,21). 15-30 minutes after cholecystokinin the bile acid concentration significantly increased. In this time the porto-venous extraction ratio rose to 0.71 while the aorto-venous extraction ratio was different. These results agree with the hemodynamics found in cirrhosis. After cholecystokinin the increase in the extraction ratio account for the blood loss by porto venous shunts which corresponds to an increase of the portal compartment.
We have applied the ion sensitive analysis of hydrogen (H2) in expired air in intervals of five minutes for five hours to determine carbohydrate malabsorption. In 19 patients with lactose malabsorption the increase in hydrogen was prior (45, SE 13 min) to healthy volunteers (142, SD 71 min, p less than 0.01). In comparison to blood glucose with the breath test no false positive results were observed. D-xylose absorption measured by breath test and renal excretion for five hours was determined in 24 volunteers and 12 patients with various intestinal diseases. There was a good correlation between both methods. In all patients the area under the concentration-time-curve was elevated (2077, SD 1260 ppm H2/5h) compared to healthy volunteers (434, SD 271 ppm H2/5h, p less than 0.01). Small bowel transit time was determined by ingestion of lactulose. In 32 healthy persons transit time was 85, SD 19 min. In 10 patients an early increase in hydrogen indicated bacterial overgrowth in the small bowel while 14C-Cholylglycine-breath test was abnormal in only six patients. The hydrogen breath test measured by ionsensitive mode is noninvasive, well tolerated, semiquantitative, and ideally suited for screening of intestinal disorders.
Two commercially available (Abbott Labs.) radioimmunoassays for determination of conjugated cholic acid and sulfoglycolithocholic acid in serum have been modified for bile acid measurements in alcoholic tissue extracts, bile, and urine. The specificity of both radioimmunoassays has been determined with regard to 27 free and conjugated bile acids. After filtration, bile acids can be measured in urine and bile without prior extraction. Tissue is homogenized and the bile acids are extracted into methanol. Urinary excretion by 64 healthy humans was 2.09 (SD 1.09) mumol of conjugated cholic acid and 8.44 (SD 8.03) mumol of sulfated glycolithocholic acid per 24 h. In liver from 10 patients with various noncholestatic liver disease, the mean concentration of conjugated cholic acid was 32.4 (SD 15.9) nmol/g wet weight. In the liver of 27 male Wistar rats, the concentration of conjugated cholic acid was 41.3 (SD 11.7) nmol/g of tissue, of sulfoglycolithocholic acid 5.1 (SD 2.3) nmol/g of tissue.
In 72 patients with chronic pancreatitis results of tbe secretin-cholecystokinin test were compared with those of several indirect test of pancreatic function (faecal fat content, chymotrypsin activity in faeces, peptide-PABA test, fluorescein-dilaurate test and weight of faeces). In 46 patients with markedly impaired pancreatic secretion the indirect tests were abnormal in 56-83% of cases. In 26 patients with normal or upper-limit-of-normal excretory function the same tests were abnormal in 15-77%. These results indicate that indirect tests of pancreatic function are of only limited value in the early diagnosis of pancreatic insufficiency.
Serum concentrations of conjugated cholic acid determined radioimmunologically were investigated for 3 hours after a test meal in 62 patients with fatty liver, 70 patients with chronic hepatitis and 30 patients with liver cirrhosis. Values were compared with results of further data from chemical pathology. Increased fasting bile acid values were found in 18% of patients with fatty liver, 13% with chronic hepatitis and in 70% with cirrhosis. Following the test meal maximum concentration increase of cholic acid conjugates was obtained after one hour. 70.5% of patients with fatty liver, 80% of patients with chronic hepatitis and 97% of patients with cirrhosis were identifiable by increased bile acid levels. Postprandial serum bile acid levels therefore have a higher sensitivity for diagnosis of liver disease than bilirubin, glutamic-oxaloacetic transaminase, alkaline phosphatase or gamma-glutamyl transferase.
Three commercially available radioimmunoassays for the determination of bile acids in serum were evaluated with respect to specificity and precision. The SLCG-radioimmunoassay (Abbott) measures chiefly cholic acid conjugates, and the CBA-radioimmunoassay (Becton-Dickinson) measures all conjugated bile acids, with an over-response to taurine metabolites. With respect to cross reactions, the performances of the CG-and the CBA-radioimmunoassays differed significantly from those stated by the manufacturers, the former showing a 32% response to taurocholic acid, the latter responding only 118% to taurochenodeoxycholic acid. At physiological concentrations of albumin + globulin, the recovery of defined cholanic acids was 85-101%. Good reproducibility was shown by the CG-radioimmunoassay in the range 0.5-10.0 mumol/l, by the CBA-radioimmunoassay in the range 1.0-25.0 mumol/l, and by the SLCG-radioimmunoassay in the range 0.5-3.0 mumol/l. There were no important differences in the inter-and intra-assay precision of the three methods.