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H Lübke

Publications and source records attributed to H Lübke.

16 recordsLinked to original sources
PubMed1995

Effects of nutrient solutions on concentration analysis of non-absorbable dilution markers--implications for studies of gastric emptying.

Gastrointestinal luminal contents may interfere with concentration analysis of non-absorbable dyes. However, non-absorbable markers are broadly used for studies of gastric emptying rates of nutrient solutions. This prompted us to evaluate the properties of non-absorbable markers to mark such nutrient solutions. In vitro concentrations of polyethylene glycol, phenol red, dextran blue, two anthroquinone dyes and inulin were determined spectrophotometrically in the presence or absence of a formula diet, single compounds of the diet or an oligo-peptide diet, and the reproducibility and validity of the analyses were evaluated. The presence of the formula diet or the oligopeptide diet seriously impaired the analyses of marker concentrations, whereas single nutrient compounds did not uniformly interfere. The analysis of polyethylene glycol and phenol red concentrations was impaired by proteins, while the analysis of inulin concentration was impaired by carbohydrates. Dextran blue and the anthroquinones were completely eliminated by protein-precipitation procedures. In conclusion, phenol red and polyethylene glycol should only be used as marker substances for protein-free meals or nutrient solutions, while inulin should not be used with meals or nutrient solutions containing carbohydrates. Marker dilution techniques cannot be recommended for measurements of gastric emptying rates of complete meals.

Coloring Agents↗
PubMed1995

Colitis ulcerosa complicated by malignant lymphoma: case report and analysis of published works.

A 51 year old woman with a two year history of ulcerative colitis developed a wide spread gastrointestinal non-Hodgkin's lymphoma of low grade malignancy (MALT-lymphoma) involving upper and lower gastrointestinal tract, spleen, and bone marrow. After chemotherapy, clinical symptoms improved and lymphocytic infiltrates disappeared. Thirty nine cases of ulcerative colitis and 22 cases of Crohn's disease complicated by gastrointestinal lymphomas reported in published works are reviewed. In inflammatory bowel diseases any dense lymphocytic infiltrates seen in biopsy specimens obtained from ulcerative colitis or Crohn's disease should be assessed to exclude gastrointestinal lymphoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1994

[Endoscopy in the intensive care unit].

The present study retrospectively evaluates all endoscopies performed on a medical intensive care unit during the period from 1986 to 1992. During these seven years, 415 endoscopies were performed of which 77.8% were done as an upper gastrointestinal endoscopy. The most frequent findings consisted in esophagitis (23.6%), ulcers of the stomach or duodenum (20.2%), esophageal varices (10.1%) and erosive-hemorrhagic gastritis (9.6%). More than 2/3 of all endoscopies were performed because of an gastrointestinal bleeding with upper bleeding being three times more frequent than lower bleeding. The endoscopy was able to identify the cause and site of bleeding with certainty or high probability in 92.8%. Esophagitis was the most frequent cause of bleeding (30.7%) followed by ulcers in the duodenum and stomach (25.6%), esophageal varices (14.8%) and erosive gastritis (13.7%). In more than 90% of patients with esophagitis a nasogastric tube had been administered during the two preceding days. Therefore, the tube is probably responsible for the esophagitis. The present data show that bleeding from esophageal lesions are about ten times more frequent in patients treated in an intensive care unit when compared to data published for the general group of patients with gastrointestinal bleeding. Considering the frequency of bleeding from esophagitis in intensive care patients, an administration of a nasogastric tube should be done only when mandatory.

Critical Care↗
PubMed1989

Age and sex and anorectal manometry in incontinence.

Although the prevalence of fecal incontinence is greater in women compared with men and in elderly subjects compared with younger subjects, data regarding the influence of age and sex on anorectal performance in continent and incontinent patients are conflicting. The authors, therefore, investigated age- and gender-related changes in anal resting and squeeze pressure as well as in sphincter relaxation after rectal balloon distention in 75 patients with fecal incontinence of different pathogenesis and in 99 continent patients by multichannel anorectal manometry. As a group, incontinent patients usually exhibit lower pressure profiles than do continent patients regardless of age and gender; however, both the resting pressure of the internal anal sphincter and the voluntary contractile pressure of the external anal sphincter are decreased with age, and both are lowered in women compared with men. Sphincter relaxation and perception of gastrointestinal events are not altered in incontinent patients, and they are not different between men and women or between elderly and younger patients.

Adult↗
PubMed1988

[Exudative enteropathy in Klippel-Trenaunay syndrome].

The triad of the Klippel-Trénaunay Syndrome consists of varicose veins, "port-wine" haemangioma of the skin and bone and soft-tissue hypertrophy with a different extension. Often an obstruction of lymphatic vessels and lymphoedema accompany the syndrome. We observed for the first time a patient with an impressive Klippel-Trénaunay-Syndrome in combination with a symptomatic exudative enteropathy. In spite of a regular intravenous protein substitution for many years, this patient had developed a monstrous elephantiasis of the lower extremities. A lymphography demonstrated a blockade of the lymph flow at the height of the middle paraaortic lymph nodes. The cysterna chyli and the Ductus thoracicus were not visualised. The measurement of 51Cr-labelled albumin excretion in the stool for two days after the intravenous injection of 3.07 MBq 51Cr showed an excretion of 17.9% of the total dose, which means an elevated gastrointestinal protein-loss. However, intestinal lymphangiectasia was not seen on histologic examination of bioptic material of duodenal and jejunal mucosa. These results show that the Klippel-Trénaunay Syndrome may be accompanied by a protein-loosing enteropathy due to obstruction of the gastrointestinal lymph flow. As the intestinal lymphangiectasia may occur locally, it is not always demonstrable directly on pathologic examination of biopsies.

Adult↗
PubMed1986

[Familial dysphagia].

The etiology of achalasia and diffuse esophageal spasm remains unknown. We report on two families (father/son, mother/son) with achalasia and esophageal spasm, respectively, who were examined by radiology, endoscopy and manometry. One patient (mother) died from aspiration pneumonia. These observations support the hypothesis of a genetic trait in some cases of esophageal motility disorders. In addition, the coincidence of familial achalasia and esophageal spasm is in support of a close relationship of both diseases. Achalasia is a potentially letal disorder.

Adult↗
PubMed1981

[The role of acid in ulcer pain (author's transl)].

In 33 patients (duodenal ulcer 11, gastric ulcer 10, nonulcerous bulbar lesions 7, anastomotic ulcer 4, antral erosions 1), approximately 4 ml HCL 0,1 N were instilled under endoscopic view directly onto the lesion, with the purpose of eliciting patients-specific pain. Five (5) patients were test-positive; their pain was reproduced (duodenal ulcer 1, gastric ulcer 2, other bulbar lesions 2), the rest was negative. Twenty-three of the 33 patients were studied during a period of spontaneous pain, 4 exhibiting a positive test; 9 were asymptomatic, and 2 of these had a positive test. The role of acid in ulcer pain remains unclear. The pertinent literature is discussed.

Female↗
PubMed1978

[Treatment of essential hypertension with a combination of propranolol, spironolactone-thiabutazide and dihydralazine (author's transl)].

In 61 out-patients with essential hypertension, grade I or II, propranolol was administered alone in increasing doses (3 x 40 mg/d or 3 x 80 mg/d) or, if there was insufficient response, with a double or triple combination consisting additionally of spironolactone (50 mg/d)-thiabutazide (5 mg/d) and dihydralazine (3 x 25 mg/d). This treatment schedule achieved normal pressures in 51 patients, in 22 on 40 mg, in 7 on 80 mg propranolol, in 16 after the addition of the diuretic, and in 6 with the triple combination. Four patients had to be excluded from the study because they developed either marked bradycardia or anxiety states or paraesthesias after propranolol (3 x 40 mg/d). On chronic beta-adrenergic blockade the serum potassium level increased slightly, but remained within normal limits. The initial value of plasma-renin activity was highest in the group of those who responded to the propranolol treatment.

Anxiety↗
PubMedDate not supplied

Prophylactic antibiotic treatment in therapeutic or complicated diagnostic ERCP: results of a randomized controlled clinical study.

The present study evaluated the effects of prophylactic administration of cefotaxime in patients undergoing therapeutic or complicated diagnostic ERCP. One hundred patients were randomized to two groups of 50 patients each. Patients in group 1 received an intravenous infusion of 2 g cefotaxime 15 minutes before endoscopy; patients in group 2 did not receive an intravenous antibiotic before ERCP (control group). Blood samples were drawn for bacteriologic cultures before endoscopy and 5, 15, 30, and 120 minutes after beginning the procedure. Bacteremia was detected by blood cultures (15- and 30-minute samples) in 4 patients who did not receive prophylactic antibiotics (Escherichia coli in 2 cases, Peptostreptococcus in 1, and Staphylococcus aureus in 1). Cholangitis or sepsis did not occur after the bacteremic episodes in any of these patients. In 4 other patients who did not receive cefotaxime-all of whom had biliary obstruction-clinical cholangitis or sepsis developed during the 3-day follow-up; ERCP had failed to decompress the biliary system completely in these 4 cases. Blood cultures identified bacteria in 3 of these 4 patients (Pseudomonas aeruginosa in 1, E. coli in 2). Thus, bacteremia or clinical sepsis developed in 8/50 patients (16%) in the control group without antibiotic prophylaxis, whereas no such episode was observed in patients who had received prophylactic treatment (chi 2 = 8.7; p < 0.01). The present results indicate that prophylactic administration of an antibiotic such as cefotaxime can reduce the incidence of bacteremia and sepsis in patients who undergo therapeutic or complicated diagnostic ERCP.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteremia↗