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Biomedical subjects

H R Koelz

Publications and source records attributed to H R Koelz.

At least 19 recordsLinked to original sources
PubMed1992

[Intramural rupture and intramural hematoma of the esophagus: 3 case reports and literature review].

Together with three of our own observations of intramural rupture (IRO) or hematoma (IHO) of the esophagus, we have analyzed 91 case reports from the literature. Precipitating factors were identified in 63% of all patients. Most frequently potentially traumatic events such as vomiting (22%) or instrumentation (17%) preceded IRO/IHO. In 21% there were disturbances of hemostasis, either alone (15%) or in addition to a traumatic event (6%). 37% of IRO/IHO were spontaneous. In 35% the typical clinical triad of acute retrosternal pain, odynophagia or dysphagia and hematemesis was complete; in 46% only two out of three symptoms were present. IRO/IHO was managed conservatively in 84% of the patients, whereas 9% required surgery for complications. 7% were operated on without a precise indication. One patient died following surgery for endoscopic perforation. The rare syndrome of IRO/IHO must be considered in patients with acute retrosternal pain. Treatment is primarily conservative and the prognosis is excellent.

Aged↗
PubMed1992

Gastric acid in vertebrates.

Gastric secretion of hydrochloric acid appears to be unique to vertebrates and is almost ubiquitous in all fishes, amphibians, reptiles, birds and mammals. Comparative anatomy and physiology suggest that gastric acid has evolved approximately 350 million years ago. The similarity of the acid-secreting mechanism across all classes of vertebrates implies a major advantage for selection, but the evidence regarding its precise purpose remains inconclusive.

Animals↗
PubMed1992

[Therapy of the acute ulcer attack].

Medical treatment of acute ulcers can be optimized by paying attention to risk factors for slow healing and for rapid recurrence. Therapy-resistant ulcers have become virtually unknown with modern drugs, so elective ulcer surgery is nowadays rarely needed for this reason. While drug therapy of acute ulcer hemorrhage is probably of little, if any, benefit for stopping bleeding, endoscopic treatment reduces the risk of continuous or recurrent bleeding, the need for emergency surgery, and mortality of this most common complication.

Acute Disease↗
PubMed1992

[Prevention of recurrence of ulcer disease: indications and choice of procedure].

In this contribution we discuss the relapse prophylaxis of ulcers by nonmedicamentous measures, by long-term drug therapy and, in particular, with inhibitors of secretion, by eradication therapy of Helicobacter pylori and by surgical therapy. Besides secondary prophylaxis (prevention of ulcer relapses), primary prophylaxis (prevention of the first episode) is also briefly treated.

Anti-Ulcer Agents↗
PubMed1978

[Therapy of duodenal ulcer using cimetidine].

55 patients with endoscopically confirmed duodenal ulcers received either cimetidine (26 patients) or placebo (29 patients) in a double-blind trial. At four weeks, 85% of the patients treated with cimetidine and 62% of those receiving placebo had endoscopically healed ulcers. This difference is not statistically significant. However, patients on cimetidine showed a more rapid and statistically significant reduction in the size of their ulcers.

Cimetidine↗
PubMed1978

[Epidemiology of duodenal ulcer (author's transl)].

The epidemiology of peptic ulcer was investigated in 1105 endoscopy patients in a Zurich city hospital and in a random nongastroenterological hospital population. A raised susceptibility for duodenal ulcer was found in young, mainly unskilled, foreign labourers. There was no raised susceptibility in female foreign workers who also suffered less often from gastric ulcer than Swiss women. A tendency to ulceration in certain other diseases previously incriminated and in alcohol and nicotine consumers was not observed. A connection between susceptibility to ulceration and migration is assumed.

Adult↗
PubMed1978

Inhibition of hepatic demethylation of aminopyrine by oral contraceptive steroids in humans.

The effect of oral contraceptive steroids (OCS) on the rate of hepatic demethylation of 14C-dimethylaminoantipyrine (DAP) was studied directly in healthy young volunteers using a newly developed noninvasive breath analysis technique. After oral administration of a trace dose of DAP the specific activity of 14CO2 in breath was determined during 6 h and expressed as half life. The half life of eighteen female and twelve male control subjects was 2.4 +/- 1.2 h (2 SD) and 2.2 +/- 0.6 h (2 SD), respectively. In seven women starting OCS a progressive prolongation of DAP half life during a single menstrual period was observed. In seventeen women who had taken OCS in 21 day cycles, for more than 3 months, the half life was significantly (P less than 0.001) prolonged (4.4 +/- 2.1 h) when measured after 21 consecutive days of OCS intake. On average, stopping OCS for 7 days or giving phenobarbital in addition to OCS shortened DAP half life significantly (from 4.4 +/- 2.1 h to 3.2 +/- 1.1 h, n = 17, P less than 0.005; and from 4.6 +/- 2.0 h to 3.2 +/- 1.0 h, n = 12, P less than 0.01, respectively). Eight of twelve women on OCS responded to OCS intake and to OCS cessation and phenobarbital, whereas four women did not respond to any of these measures. These data suggest that inhibition of hepatic demethylation of DAP by OCS is time dependent and reversible. The extent of inhibition appears to be an individual characteristic of a given person.

Adult↗
PubMed1978

Effect of intraduodenal peptone on the lower esophageal sphincter pressure in the dog.

The role of the duodenum in the regulation of the lower esophageal sphincter pressure (LESP) was investigated in 4 unrestrained dogs equipped with a chronic Komarov type esophagostomy, a cutaneous duodenal fistula, a gastrojejunostomy, and a Y anastomosis between the distal end of the duodenum and the midjejunum. Installation of NaCl solution into the duodenum or into the stomach did not effect LESP during the following 60-min observation period. Peptone instillation into the duodenum or into the stomach produced a sustained elevation LESP. The rise of LESP was significantly greater after duodenal than after gastric instillation. Duodenal peptone did not raise serum gastrin. It is concluded that the duodenum may be an important regulator of LESP in the dog and that this effect is not mediated by circulating gastrin.

Animals↗
PubMed1978

Haemolytic activity in gastric and duodenal juice.

Gastric juice was aspirated during upper endoscopy in 141 patients. In 48 patients duodenal juice was also aspirated. pH, bilirubin concentration, and haemolytic activity were measured in each sample. Patients with atrophic gastritis and subtotal gastrectomy (Billroth II) showed the highest concentrations of haemolytic activity and bilirubin in their gastric juice. Gastric juice of patients with gastric and duodenal ulcer, with gastric erosions, and with antral gastritis was not statistically different from the control group in which 22 of 32 persons had a positive haemolytic activity. The ratio of bilirubin and haemolytic activity concentration was significantly higher in duodenal than in gastric juice. The reason for this phenomenon remains unknown. It is concluded that for practical purposes bile staining more than haemolytic activity of gastric contents is a quite sensitive, though unspecific, sign of abnormal duodenogastric reflux.

Bilirubin↗
PubMed1977

Calcium ion uptake induced by cholinergic and alpha-adrenergic stimulation in isolated cells of rat salivary glands.

Adrenaline (10(-5) M) and carbamylcholine (10(-4) M) stimulate 45Ca2+ uptake into isolated cells of rat submandibular galnd and parotid glands. In the presence of the alpha-adrenoreceptor blocking agent phentolamine, adrenaline stimulation of 45Ca2+ uptake is abolished. The beta-adrenergic stimulant isoproterenol has no effect on 45Ca2+ uptake. Carbamylcholine induced 45Ca2+ uptake is inhibited by atropine. The Ca2+ ionophore A23187 stimulates 45Ca2+ uptake, whereas dibutyryl cyclic adenosine 3',5'-monophosphate and dibutyryl cyclic guanosine 3',5'-monophosphate have no effect on 45Ca2+ uptake. A graphical analysis of the 45Ca2+ uptake curves reveals at least two phases: a fast phase and a slow phase, both of which are stimulated by adrenaline and carbamylcholine. The 45Ca-exchangeable pool size is increased by adrenaline and carbamylcholine in both the fast and the slow phases. These results suggest that alpha-adrenergic and cholinergic agonists act by increasing the rate of Ca2+ transfer into the cells of the parotid and submandibular salivary glands most probably through an increase of the cell membrane permeability for Ca2+.

Amylases↗
PubMed1977

[Endoscopic diagnosis of oesophagitis: problems of differentiation from normal (author's transl)].

The diagnostic significance of endoscopically early signs of oesophagitis in the absence of macroscopic evidence of epithelial abnormalities has been studied prospectively. Changes from the usually observed shininess, pale-pink colour, smooth texture, regular capillaries, sharp Z-line and a decreased mechanical resistance of the mucosa to mechanical damage do not indicate oesophagitis. Nor should one infer gastro-oesophageal reflux from these endoscopic findings. They are presumably ageing changes in the oesophagus.

Aging↗
PubMed1977

[The role of the duodenum in the regulation of the lower esophagus sphincter].

Instillation of a 20% peptone solution into the isolated duodenum causes a significant increase of LES-pressure in the dog. No comparable increase of LES-pressure after instillation of a 0.9% saline solution into the duodenum or of 20% peptone solution into the stomach is observed. As shown in this investigation, it is possible that the duodenum regulates the LES-pressure in the dog.

Animals↗