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Biomedical subjects

H Rau

Publications and source records attributed to H Rau.

12 recordsLinked to original sources
PubMed1992

Gallstones in acromegalic patients undergoing different treatment regimens.

The frequency of gallstones during long-term treatment with the somatostatin analogue octreotide reported in different studies varies from 0% to 50%, the reason for this variation being unknown. Therefore, we examined 58 acromegalic patients undergoing different treatment regimens for the frequency of gallstones. Thirteen were treated with octreotide, 20 with bromocriptine, and 25 had no medical treatment after successful neurosurgery. Also, 58 patients without known gallbladder disease served as controls. The postprandial gallbladder contraction was also investigated in 27 acromegalic patients (10 with octreotide, 10 with bromocriptine, and 7 with no medical therapy). Ten of the 58 acromegalic patients were found to have gallstones, 4 of 25 receiving no medical treatment, 4 of 20 treated with dopamine agonists, and 2 of 13 treated with octreotide. In 9 of the 58 control patients, gallstones were detected. Although in the octreotide group the gallstones were newly formed under therapy, there was no difference in gallstone prevalence between the different treatment regimens and the control group. However, the postprandial gallbladder contraction was significantly more often inhibited during octreotide therapy, and this effect was most pronounced during the first hours following injection. Differences in the timing of injections therefore may be an explanation of the variable incidence of cholelithiasis in the different studies.

Acromegaly↗
PubMed1992

Physiological and psychological differentiation of bidirectional baroreceptor carotid manipulation in humans.

We investigated a phase-related-external-suction (PRES) method of bidirectional carotid stimulation which, unlike other methods, is not readily discriminable for direction (excitation vs. inhibition). Thirty-two subjects were first given 128 6-s PRES trials (64 each excitatory and inhibitory) which were signaled by two tones of differing frequency. There followed a 20-trial discrimination phase where subjects' task was to identify excitatory and inhibitory PRES trials (randomly presented) in terms of the two tone signals. Physiological (HR) discrimination was bidirectional (deceleration and acceleration for excitatory and inhibitory PRES trials, respectively), reflex-like (no habituation), but asymmetrical in magnitude (larger decelerations than accelerations), and topography (e.g., presence of a short latency deceleration). Group psychological discrimination was absent, although two subjects had a 100% hit rate on the discrimination test. There were, however, no systematic HR changes associated with these two subjects. Finally, the small-magnitude (2-3 bpm) physiological HR reflex was markedly augmented by what appeared to be a psychological, attentional factor. Accordingly, while the results indicated a dissociation between physiological and psychological differentiation, there was also evidence of a psychological factor (attention) influencing a physiologically induced reflex.

Adult↗
PubMed1992

PRES: the controlled noninvasive stimulation of the carotid baroreceptors in humans.

To study physiological and psychological effects of baroreceptor activity, the cervical neck cuff technique has been frequently used to stimulate the carotid baroreceptors mechanically. Using this technique, no satisfying control conditions to date have been available. Because the carotid stretch receptors are sensitive not only to the pressure level, but also to the rate of change, it is possible to manipulate the receptor firing through changes in carotid pulse amplitude. The device described here relies on the application of short changes in cuff pressure tied to different phases within the cardiac cycle (phase related external suction (PRES)). A brief external suction during systole has potent stimulatory effects on baroreceptors whereas the application of the very same pressure pulse during diastole inhibits the firing burst associated with the pulse wave. To allow an ongoing period of stimulation, a sequence of alternating negative/positive pressure pulses is applied. In the stimulation condition, the R-wave of the electrocardiogram triggers a negative pulse which is followed by a positive one during diastole. In the control condition this relationship is reversed. Two experiments are reported confirming different baroreceptor effects of the two conditions. PRES allows for blind or double-blind experiments to investigate effects of baroreceptor activity on physiology and behavior.

Adult↗
PubMed1992

Bromocriptine treatment over 12 years in acromegaly: effect on growth hormone and prolactin secretion.

It is not known whether bromocriptine treatment in acromegaly can be implemented for a life-long period. To elucidate this problem, the secretory GH and PRL states of 12 patients with acromegaly were determined, before bromocriptine treatment, under therapy (15.0 +/- 6.8 mg/day for 12 +/- 3 years; mean +/- SD) and during two-weeks long drug withdrawal after long-term treatment, respectively. Before therapy, all patients showed a non-sufficient GH suppression after oral glucose load (greater than 2 micrograms/l), whereas under dopaminergic treatment the post-glucose GH levels of three patients fell below 2 micrograms/l; normal IGF-I concentrations were found in five patients. However, under bromocriptine, only two patients showed GH suppressions below 2 micrograms/l following glucose, accompanied with normal IGF-I levels. During bromocriptine withdrawal, GH secretion at 60 min in the oral glucose tolerance test increased significantly (17.0 +/- 15.5 vs 5.7 +/- 5.2 micrograms/l; p less than 0.01); the mean IGF-I level rose from 2.1 +/- 0.8 to 4.9 +/- 2.2 kU/l (p less than 0.01). IGF-I was normal during bromocriptine cessation in only one patient; none of the 12 patients showed a GH suppression below 2 micrograms/l after oral glucose load. Under dopaminergic treatment hyperprolactinemia could not be detected. In conclusion, bromocriptine led to a stable suppression of both GH hypersecretion and--if present--concomitantly elevated PRL levels. Severe side effects or a further tumor growth could not be observed. Thus, the data of the longest follow-up investigation that has so far been published indicate that effective life-long bromocriptine therapy seems to be possible in selected patients with acromegaly.

Acromegaly↗
PubMed1992

[Modification of autoregulation of intrinsic physical processes in field-dependent subjects: a study of performance in heart rate biofeedback].

Witkin, the founder of the concept of "field dependence", assumed that there is a relationship between field dependence and body perception. However, this hypothesis was never investigated experimentally in a well-controlled study. Twenty healthy subjects learned to increase and decrease their heart rate dependent upon two discriminative stimuli. In order to increase and decrease their heart rate they received exteroceptive feedback (movements of a rocket-ship on a video screen). Each trial lasted 6 s. The distance of the rocket-ship from a certain point indicated the amount of the achieved increase or decrease. Field dependent subjects scoring higher in field dependency as measured by the Embedded Figures Test were poorer at heart rate control on feedback and transfer trials (test trials with feedback removed) than were subjects scoring low in field dependency. This result may be of therapeutic interest in the application of behavioral medicine to psychosomatic and psychiatric disorders.

Adult↗
PubMed1992

[Minimally invasive interventions in solitary liver cysts].

Large intrahepatic cysts need surgical intervention when becoming symptomatic. In case of non-parasitic solitary cysts different surgical treatments are available. We performed three different minimal-invasive procedures in 8 patients. Good results were obtained by laparoscopic extended deroofing of the cyst. Indications and technical performance are presented.

Adult↗
PubMed1978

[Focal migraine attacks without headaches (author's transl)].

The migraine without headaches is a special form of focal migraine, a migraine accompagnée without headaches. The diagnostic classification of the transient focal disturbances is made possible by careful analysis of the attacks. This type of attack starts in a localized manner (primarily in the ophthalmic area), develops corresponding to the cortical representation, and is not always restricted to one vascular area. Typical is the slow spread of symptoms over a period of ten minutes, on the average. This allows a differentiation from transient ischemic attacks or focal epilepsy. The diagnosis is supported by hereditary factors, early onset of manifestation and change of the side of focal symptoms (in 11 of 16 patients). Of 409 migraine patients, 16 were such cases, corresponding to an occurrence of 4%. There were no signs of symptomatic etiology for these transient focal disturbances.

Adult↗
PubMed1975

[Results of cisternoscintigraphy. A proscpective and retrospective study].

In a retrospective and prospective study the scintigraphically measured kinetics of intrathecally injected tracers are classified and compared with the final clinical diagnoses confirmed by additional examinations and clinical course. The results of the studies show characteristic dynamics of the tracer in patients without neurological diseases, whereas typically abnormal images are demonstrated in different neurological diseases.

Adult↗
PubMed1975

[Vestibular dizziness. Differential diagnosis and therapy].

Dizziness includes a wide variety of subjective sensations which are not conclusive as to their localization or pathogenesis. Even in the absence of other symptoms an analysis of dizziness, including consideration not only of its occurrence but also of its quality and course, can suggest several possibilities for differential diagnosis. We differentiate between positional vertigo, permanent vertigo and attacks of dizziness, which may be of long or only short (seconds to few minutes) duration. Based on this classification the differential diagnosis of vestibularly-induced dizziness, which ranges from distinct entities of peripheral disease (acute vestibulopathy, Ménière's disease) to symptomatic forms of peripheral or central pathogenesis, is discussed. The symptomatic medical treatment of vestibular dizziness is based on sedation of the central vestibular system. Translabyrinthine vestibular neurectomy is the treatment of choice for drug resistant Ménière's disease with a high frequency of attacks.

Acute Disease↗
PubMedDate not supplied

Renal functional response to the mushroom poison gyromitrin.

The poison gyromitrin, found in the edible false morel Gyromitra esculenta Fr. ex Pers., caused in rats an increased diuresis in which urine was produced with a weak alkaline pH, a high excretion of sodium (530%), and potassium (210%). The observed increase lasted for about 12 h and was followed by a rentention with regard to the volume and the Na-excretion for about 72 h. On the basis of [3H] inulin excretion an increased glomerular filtration was determined followed by a decrease 12 h after application of gyromitrin. An increase of creatinine and urea in the serum could not be established during the retention phase. The diuresis as well as the excretion of sodium could be antagonized by injection of an equimolar dose of pyridoxine. The hydrazine derivative N-methyl-N-formylhydrazine (MFH), which is formed rapidly from gyromitrin by hydrolysis, was without any effect on the renal function. In order to explain the effectiveness of the relatively lipophilic gyromitrin, the non-effectiveness of the more hydrophilic hydrazine MFH and the blockade of the gyromitrin effect by pyridoxine, a mechanism involving the central nervous system is discussed.

Acetaldehyde↗