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Biomedical subjects

H Kasper

Publications and source records attributed to H Kasper.

At least 19 recordsLinked to original sources
PubMed1992

[Diabetic gastroparesis and gallbladder disease. Ultrasound diagnosis after multiple-component meals].

Thirty insulin-dependent diabetics (16 women, 14 men, mean age 37.7 [17-74] years) and 12 controls (eight women and four men; aged 20-58 years) were studied by real-time ultrasound before and after each of three meals to assess gastric and gallbladder motility. The diabetics were grouped according to the results into those without (n = 17) and those with diabetic autonomic neuropathy (n = 13). Antral cross-section provided the criterion for gastric emptying. It decreased significantly more slowly in diabetics with autonomic neuropathy than in the other two groups. The difference during the postprandial observation period of 240 min became the greater the longer the interval after the test meal (multivariance analysis: P < 0.001). Gallbladder emptying, too, was slowest in diabetics with autonomic neuropathy (P < 0.05). These results indicate that abnormalities of gastric and gallbladder emptying in diabetics can be recognized by measuring antral cross-section and longitudinal gallbladder area on fasting and 180 min after a test meal.

Adolescent↗
PubMed1992

Effect of butyrate enemas on the colonic mucosa in distal ulcerative colitis.

Short-chain fatty acid irrigation has been shown to ameliorate inflammation in diversion colitis. In this study the effect of butyrate enemas was tested in 10 patients with distal ulcerative colitis who had been unresponsive to or intolerant of standard therapy for 8 weeks. They were treated for 2 weeks with sodium butyrate (100 mmol/L) and 2 weeks with placebo in random order (single-blind trial). Before and after treatment, clinical symptoms were noted and the degree of inflammation was graded endoscopically and histologically. Rectal proliferation was assessed by autoradiography. After butyrate irrigation, stool frequency (n/day) decreased from 4.7 +/- 0.5 to 2.1 +/- 0.4 (P less than 0.01) and discharge of blood ceased in 9 of 10 patients. The endoscopic score fell from 6.5 +/- 0.4 to 3.8 +/- 0.8 (P less than 0.01). The histological degree of inflammation decreased from 2.4 +/- 0.3 to 1.5 +/- 0.3 (P less than 0.02). Overall crypt proliferation was unchanged, but the upper crypt-labeling index fell from 0.086 +/- 0.019 to 0.032 +/- 0.003 (P less than 0.03). On placebo, all of these parameters were unchanged. These data support the view that butyrate deficiency may play a role in the pathogenesis of distal ulcerative colitis and that butyrate irrigation ameliorates this condition.

Adult↗
PubMed1991

Effect of starch malabsorption on fecal bile acids and neutral sterols in humans: possible implications for colonic carcinogenesis.

Epidemiological and experimental studies indicate a strong association between an elevated colon cancer risk and increased fecal excretion of secondary bile acids, neutral sterols, and prolonged gastrointestinal transit time. Starch malabsorption, on the other hand, has been reported to be a possible protective factor in colon carcinogenesis. To study the impact of starch malabsorption on these parameters, 12 healthy volunteers consumed a diet rich in starch for two 4-week periods. During a double-blind crossover trial they received the alpha-glucosidase inhibitor acarbose (BAY g 5421) in one of the study periods and placebo in the other. During acarbose treatment stool wet weight increased by 68%, stool dry weight by 57%, and gastrointestinal mean transit time by 30%. Fecal concentrations (mg/g dry weight) of the neutral sterols coprostanol, coprostanone, campesterol, 4-cholesten-3-one, and beta-sitosterol decreased by 36.8, 48.7, 42.1, 34.6, and 39.4%, respectively, under acarbose. Concentrations of the major secondary bile acids, deoxycholic and lithocholic acid, decreased by 59.9 and 52.2%, respectively. In spite of an increased stool weight, also daily excretion (mg/day) of these two bile acids was lower under acarbose (47.9 and 36.6%, respectively) compared to placebo, whereas excretion of the main primary bile acid, cholic acid, rose from 22.58 mg/day to 379.80 mg/day during the acarbose period. The changes in fecal bile acid and neutral sterol excretion found during acarbose treatment may explain a protective effect of starch malabsorption on colon cancer development.

Acarbose↗
PubMed1991

Colonic fermentation of potato starch after a freeze-thaw cycle.

To estimate colonic carbohydrate fermentation following a potato meal, 13 healthy volunteers consumed 375 g potatoes containing 60 g starch on three different occasions in random order: (A) potatoes boiled and consumed fresh at 60 degrees C; (B) potatoes boiled, frozen, thawed and consumed at 20 degrees C; and (C) potatoes boiled, frozen, thawed, reheated to 90 degrees C, and consumed at 60 degrees C. End-expiratory breath hydrogen (H2) was measured every 15 min for 10-14 hr with a selective electrochemical cell. The extent of colonic carbohydrate fermentation (AUC = area under the breath H2 concentration vs time curve) in experiment B was significantly higher (+186%, P less than 0.002) than in experiment A. The breath hydrogen AUC in experiment C was higher than in experiment A (+48%, P less than 0.04) but lower than in experiment B (-94%, P less than 0.003). It is suggested that structural alterations of the starch molecule occur during freezing, thawing, and reheating and alter the availability of carbohydrates for fermentation by colonic anaerobes.

Adult↗
PubMed1991

Magnetic search coil system for linear detection of three-dimensional angular movements.

The design of a two-dimensional (2D) magnetic field search coil system based on the phase detection principle is described. The system was developed to record horizontal and vertical eye and head movements of small, unrestrained laboratory animals. It is also applicable for measuring three-dimensional (3D) eye and head movements in primates and man. The output is linear over 355 degrees in the horizontal plane and over +/- 60 degrees in the vertical direction. The procedure of recording 3D eye and head movements is discussed.

Animals↗
PubMed1990

[Diseases of the large intestine in the aged. Constipation--diverticulosis--tumors--ischemia].

In no other part of the gastrointestinal tract is there such a wide range of incidence of pathological changes and such a marked increase in incidence with increasing age as the colorectum. In view of the increasing numbers of old people in the general population, therefore, gastroenterologists are increasingly being confronted with these diseases. The most important in practical terms are constipation, colonic diverticulosis with its complications, benign and malignant tumors, and the damages to the wall of the colon resulting from deficient perfusion. In the case of geriatric patients, the evaluation of the symptomatology, so important for the diagnosis, can be difficult, since the complaints may be overemphasized owing to anxious self-observation, or, owing to a reduction in cerebral capacity, are not adequately appreciated and reported.

Aged↗
PubMed1989

Comparison of glycemic response and insulin requirements after mixed meals of equal carbohydrate content in healthy, type-1, and type-2 diabetic man.

The postprandial insulin requirements after three mixed meals of equal carbohydrate and energy content were assessed in 10 type-1 and 12 type-2 diabetics by a glucose-controlled insulin infusion system. These were compared with the glycemic response to the same meals of 10 healthy individuals (glycemic index). In type-1 diabetics, we found the highest insulin requirements after consumption of a continental breakfast (low fibre, low protein, high fat). Ten percent less insulin was infused after milk (low fat, high protein) and 30% less after an English breakfast (high fibre, high protein). Type-2 diabetics showed no significant differences in insulin requirements between the three test meals. The glycemic response in healthy individuals had no relation to these insulin requirements. Continental and English breakfast had a similar glycemic effect, whereas milk produced only 30% of the blood glucose response observed after the continental breakfast. These results indicate that neither the carbohydrate content (exchange lists) nor the glycemic index enable prediction of postprandial insulin requirements in insulin-deficient diabetes. For this purpose, we propose the insulin-need index, elaborated by testing whole meals in closed-loop experiments with type-1 diabetics.

Adult↗
PubMed1989

Faecal short-chain fatty acids after colonic surgery.

Carbohydrates from dietary fibre and starch are broken down by the anaerobic microflora to short-chain fatty acids (SCFA) in the caecum and ascending colon. In this study the adaptation of the remaining distal colon or ileum to resection of various lengths of the proximal colon was investigated. Faecal SCFA concentrations (mumol/g wet weight) were measured after right hemicolectomy (n = 10), subtotal colectomy (n = 3) and total colectomy (n = 8) and compared with SCFA in control subjects (n = 21). After right hemicolectomy faecal SCFA (48.7 +/- 5.6) were not different from values obtained in control subjects (47.8 +/- 4.0). SCFA levels after subtotal colectomy (14.5 +/- 0.8) and total colectomy (6.7 +/- 1.4) were significantly lower than after right hemicolectomy and in controls. It is concluded that, after right hemicolectomy, the remaining left colon offers conditions favourable to bacterial fermentation. After subtotal or total colectomy, however, postoperative conditions do not allow a normal fermentative activity. The consequences of a reduced SCFA production for sodium and fluid absorption are discussed.

Adult↗
PubMed1985

Output-dependent non-parallel enzyme secretion of the human pancreas.

In order to study the question as to whether the enzyme ratios in the pancreatic juice change with the secretion rate, we analysed the enzyme outputs of 20 healthy volunteers under combined stimulation with varying doses of cholecystokinin (0; 0.5; 1.0 or 1.3 IDU X kg-1 X h-1), administered in random order, plus a constant dose of secretin (0.5 CU X kg-1 X h-1). The outputs of the individual enzymes correlated significantly (p less than 0.0001) to the corresponding amylase outputs in the form of power model regressions. Mathematical transformation of these curvilinear regressions permitted a comparison of their courses. This analysis revealed that the enzyme ratios in the pancreatic secretion change continuously at increasing outputs in favour of lipase greater than chymotrypsin greater than amylase. The shift in the ratio of lipase to trypsin and to amylase and that of chymotrypsin to amylase was significant (p less than 0.01).

Adult↗
PubMed1979

The effect of dietary fiber on postprandial serum digoxin concentration in man.

The postprandial digoxin concentrations in serum were measured for 4 hr by radioimmunological assay in six healthy volunteers who had received 0.8 mg beta-acetyldigoxin by the oral route. Digoxin was given together with a formula diet containing as admixture, respectively, wheat bran, microcrystalline cellulose, pectin, carrageenan, and carob seed flour. The various additions did not reduce the mean digoxin concentrations in serum. After carob seed flour, the concentrations were significantly (P less than 5%) higher, as compared to the control. After microcrystalline cellulose, pectin, and wheat bran the mean peak concentrations were reached later than in the control state.

Acetyldigoxins↗
PubMed1979

The effect of dietary fiber on the postprandial serum vitamin A concentration in man.

In 11 normal female subjects, ages 19 to 22 years, the postprandial serum vitamin A concentration was measured 3, 5, 7, and 9 hr after oral administration 300,000 IU vitamin A-palmitate given with a formula diet to which was added 40 g wheat bran, 40 g microcrystalline cellulose, 15 g apple pectin, 15 g guar flour, 15 g carob bean flour, or 20 g carrageenan. When vitamin A was given together with guar flour and apple pectin 3 hr after starting the experiment, the mean serum vitamin A concentration was significantly higher than in controls. Areas under serum vitamin A concentration curves, taken as a measure of the amount of vitamin A absorbed, were significantly higher when the vitamin was administered together with the investigated dietary fiber substances.

Adult↗
PubMed1979

Dietary fiber and nutrient intake in Crohn's disease.

The mean daily intake of dietary fiber, sugar, starch, fat, protein, and total energy was determined in 35 patients with Crohn's disease and 70 normal controls by obtaining individual dietary histories. For each patient with Crohn's disease there two controls, matched for age, sex, and socioeconomic background. In the patients with Crohn's disease the mean dietary fiber intake was established as 26.6 +/- 1.4 g/day, compared to 22.3 +/- 0.9 g/day in the controls, and was thus significantly higher (P less than 0.05). When compared with the controls, the patients with Crohn's disease also exhibited a significantly higher consumption of sugar 156 +/- 14 versus 91 +/- 5 g/day (P less than 0.001), starch (211 +/- 10 versus 170 +/- 9 g/day (P less than 0.01)), and total energy (14.4 +/- 0.7 versus 12.3 +/- 0.5 MJ/ day (P less than 0.01)).

Adolescent↗
PubMed1979

Dietetic treatment of obesity with low and high-carbohydrate diets: comparative studies and clinical results.

In spite of numerous studies in the literature, it is still questionable as to whether the isocaloric exchange of carbohydrate and fat, in the form of a diet, leads to different degrees of weight loss. In comparative studies, obese patients given a low-carbohydrate (4.14 MJ [1000 kcal]) formula diet (diet Ia) lost 14.0 +/- 1.4 kg and those given an iso-energetic high-carbohydrate diet (diet Ib) 9.8 +/- 0.9 kg. The degree of weight loss was significantly different. Daily weight losses were 362 g and 298 g respectively. Comparative studies of high and low-carbohydrate (7.83 MJ [1900 kcal]) formula diets (diets IIa and b) with a greater number of calories did not show any significant difference. However, there was a greater mean weight loss with the low-carbohydrate diet (351 g/day) compared with that under the high-carbohydrate diet (296 g/day). Evaluation of 117 patients treated with formula diets resulted in a weight loss of over 9 kg in 102 obese patients and over 18 kg in 52 patients. The good response to the low-carbohydrate diet was partly responsible for the successful therapy.

Adult↗
PubMed1979

Therapy of Crohn's disease with metronidazole -- an uncontrolled trial --.

Twelve patients with Crohn's disease (C.D.), in whom there was no improvement of symptoms and signs under protracted corticosteroid and salicylazosulphapyridine medication, were treated with 1 000 mg metronidazole (M.) daily. Crohn's Disease Activity Index (CDAI) was used as a criterion of therapeutic response. Seven patients showed improvement of symptoms with a concomitant fall of the CDAI from 300 +/- 84 to 56 +/- 32 (mean +/- SD) after 10 to 45 days. In one patient, therapeutic success was judged to be doubtful, a negative result being obtained in 4 patients. During follow-up, which was maximally 21 months, patients failed to relapse while receiving a maintenance dose of 250 and 500 mg of M. per day. -- Judicious attempts at drug withdrawal were undertaken during the first 6 months but were invariably followed by a relapse. -- Metronidazole given over a protracted period did not give rise to side-effects. -- A reduction of anaerobic bacterial invaders of the intestine is suggested to underlie the favourable therapeutic effect of M.

Adolescent↗