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Biomedical subjects

H Schomerus

Publications and source records attributed to H Schomerus.

At least 19 recordsLinked to original sources
PubMed1990

Evaluation of the Crohn's Disease Activity Index (CDAI) and the Dutch Index for severity and activity of Crohn's disease. An analysis of the data from the European Cooperative Crohn's Disease Study.

In the European Cooperative Crohn's Disease Study a general documentation of clinical and laboratory data was made at the entry into the study in 452 patients. These patients were in different states of their disease from quiescent to very active. In all patients the Crohn's Disease Activity Index of Best (CDAI) and the Dutch Index of van Hees was calculated. Three gastroenterologists did a global clinical rating and a separate laboratory rating without knowledge of the indices. The ratings were then correlated with the indices in the individual patients. The clinical rating correlated well with the CDAI (r = 0.88) and less with the Dutch Index (r = 0.672). On the other hand the laboratory rating showed a better correlation with the Dutch Index (r = 0.742) than with the CDAI (r = 0.573). This demonstrates that the CDAI preferably is an estimate of the clinical severity of the disease and not of the activity of inflammation. Vice versa the Dutch Index is mainly reflecting the activity of the inflammatory process.

Colitis↗
PubMed1987

[The disease picture of hepatic encephalopathy].

Hepatic encephalopathy implies disturbances of consciousness, intellectual function, behavior and neuromuscular function in the course of diseases of the liver. By employing psychometric and neurophysiologic methods, functional disturbances can be demonstrated well before clinical manifestation of encephalopathy. This latent form of encephalopathy is especially disturbing for patients doing manual work. Treatment should be started during this early phase of the disease.

Brain↗
PubMed1986

[Branched-chain amino acids in the treatment of latent porto-systemic encephalopathy. A placebo-controlled double-blind cross-over study].

In a doubleblind cross-over placebo-controlled trial the efficiency of oral treatment with branched chain amino acids was investigated in 22 inpatients with liver cirrhosis. In all patients evidence of latent (subclinical) portalsystemic encephalopathy was obtained by using an extensive psychometric test programme. Patients received a defined diet of 35 cal/kg/day containing 1 g of protein. In addition, branched chain amino acids or casein in a dosage of 0.25 g/kg/day was administered in a cross-over fashion, each for 1 week. Semiquantitative nitrogen balance increased during both treatments, with a tendency towards a larger increase during branched chain amino acid treatment. At the same time ammonia concentration tended to decrease during branched chain amino acid treatment. Taking into account the cross-over design, significant improvements attributable to branched chain amino acid treatment could be demonstrated in psychomotor functions (line tracing, tapping, steadiness, auditory reaction time), attention (digit table), and practical intelligence (digit symbol, number connection test).

Administration, Oral↗
PubMed1985

Serum inhibitory factors (SIF) are of prognostic value in acute viral hepatitis.

Serum inhibitory factors (SIF) were analysed in relation to the natural course of acute viral hepatitis in 81 patients followed over a period of 1 year. 63 patients recovered completely (group 1), and 18 had a protracted course of hepatitis (group 2) as shown by persistent transaminase activity 6 months after onset. 11 patients in group 2 still had signs of liver disease after 1 year. A gradual fall of SIF activity (in 47 patients) heralded resolving hepatitis, whereas persistence of SIF (in 8 patients) correlated with inflammatory activity and failure of hepatitis B viral antigen elimination. Absence of SIF activity was associated with either an uncomplicated or a chronic course of hepatitis in 23 and 3 patients, respectively. Repeated determination of SIF may help to predict the final outcome of hepatitis. Both excessive and failure of SIF production may result in the development of chronic liver disease.

Acute Disease↗
PubMed1985

Branched chain amino acids in the treatment of latent portosystemic encephalopathy. A double-blind placebo-controlled crossover study.

Branched chain amino acids have been recommended for the treatment of portosystemic encephalopathy based on the false neurotransmitter hypothesis. This hypothesis implies that by correction of the deranged amino acid pattern in the blood of cirrhotics, false neurotransmission and then portosystemic encephalopathy is improved. We conducted a double-blind crossover placebo-controlled trial in 22 inpatients with liver cirrhosis and obtained evidence of latent (subclinical) portosystemic encephalopathy using an extensive psychometric test program. Patients received a defined diet of 35 cal/kg X day containing 1 g of protein. In addition, branched chain amino acids or casein in a dosage of 0.25 g/kg X day was administered in a crossover fashion, each for 1 wk. Semiquantitative nitrogen balance increased during both treatments, with a tendency of a larger increase during branched chain amino acid treatment. At the same time ammonia concentration tended to decrease during branched chain amino acid treatment. Taking into account the crossover design, significant improvements attributable to branched chain amino acid treatment could be demonstrated in psychomotor functions (line tracing, tapping, steadiness, auditory reaction time), attention (digit table), and practical intelligence (digit symbol, number connection test).

Adult↗
PubMed1985

[Severe liver damage as a drug-allergy reaction to cefoperazone].

A 20 year old man was treated with cefoperazone for 25 days because of a local infection after an open fracture complicated by pseudarthrosis. Severe liver damage was noted on 25th day of cefoperazone treatment. There was extreme elevation of transaminases and alkaline phosphatasis as well as jaundice and prolonged prothrombin time. Upper GI bleeding, fever and acute renal failure developed. All symptoms disappeared after cessation of cefoperazone. A causal relationship between the drug and liver damage seems likely because of a positive lymphocyte stimulation test, the time relation between cefoperazone therapy and change in liver function as well as the development of eosinophilia. Other causes of liver damage could be excluded. The pathogenesis of liver damage, upper GI bleeding and acute renal failure is discussed.

Adult↗
PubMed1984

[Diagnostic value of unselected biopsies during gastroscopy].

In a prospective study 1414 unselected biopsies were obtained during 509 consecutive gastroscopies. Concordance between endoscopic and histological diagnosis was judged by means of the kappa coefficient. Best agreement was obtained with biopsies from the duodenal bulb, at 67.6% (kappa = 0.39). With biopsies from the body of the stomach agreement was only 35.7% (kappa = 0.12), from the antrum 28.8% (kappa = 0.10). Degree of agreement between endoscopic and histological result was independent of the instrument used, but was clearly dependent on the examining doctor and the number of examinations. The results suggest that clinically significant disease is often overlooked during endoscopy alone, unless simultaneously obtained unselected biopsies are examined at the same time. Thus, endoscopic examination alone missed Crohn's disease, chronic atrophic gastritis and various degrees of dysplasias. Unselected biopsy aids in objectifying the gastroscopic findings and in securing the diagnosis of various diffuse gastric mucosal changes.

Biopsy↗
PubMed1984

Measurements of local PO2 in the resting skeletal muscles of rats with portocaval anastomosis (PCA) under normoxic conditions.

Direct measurements of local oxygen pressure by means of platinum multiwire electrode were performed in rats to investigate the effect of an end-to-side portocaval shunt procedure on muscle tissue oxygenation. Compared with intact rats and/or sham operated animals, rats with portocaval anastomosis showed a significant increase of muscle tissue oxygenation with nearly bellshaped pO2 histograms. This considerable increase in tissue oxygenation might appear to be due to the well known PCA induced hyperdynamic cardiovascular state.

Animals↗
PubMed1983

[Seroprevalence of Q fever in an endemic area of southern Germany].

In a random study among inhabitants of a village in a region of South Germany in which Q fever is endemic, seroprevalence and the significance of known risk factors for Q fever were investigated. Of the 1150 inhabitants, 948 (older than 14 years, resident in the endemic region for more than six months) were included in the study (target group). Within eight months 715 subjects (total group) were actually tested. The total group did not differ from the target group demographically. There were 136 seropositive persons (19%) with a dominance of males (n = 86). Relatively at risk of seropositivity were: males, aged 14-19 years, women, aged 40-49 years; those resident less than 200 m from the next farmhouse; agricultural workers; those in contact with animal products and farm animals. The known greater risk for males is, as shown in these results, due to the specific agricultural activity of this population group, with increased contact with lamb meat, pigs and chickens.

Adolescent↗
PubMed1983

[Bronchopulmonary infiltrates in chronic inflammatory bowel disease].

High temperatures, night sweat, chest pain, cough and dyspnoea suddenly occurred in a 54-year-old patient. The serious disease was accompanied by variable pulmonary infiltrations. Chemical pathology showed maximally increased sedimentation rates, slight leucocytosis and anaemia. Complete serology was negative. The occurrence of large intestinal ileus required laparatomy and after commencement of treatment with steroids the overall state improved, pulmonary symptoms disappeared, and radiographically demonstrable infiltration were clearly regressing. Histology revealed presence of acute ulcerative colitis. Lung infiltrates probably represented extraintestinal manifestation of the chronic inflammatory bowel disease. In contrast to experience from the literature lung infiltrations in this case preceded clinical manifestations of the underlying disease.

Colitis, Ulcerative↗