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Biomedical subjects

H Stiegler

Publications and source records attributed to H Stiegler.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Effect of prostaglandin E1 on amino acid metabolism of human skeletal muscle].

The influence of an intraarterial infusion of PGE1 on the amino acid metabolism of human skeletal muscle was examined in healthy volunteers using the forearm technique. A continuous increase of perfusion from 2.9 +/- 0.1 ml/100 g x min to 5.4 +/- 1.5 after 60 min could be observed. Muscular amino acid balances were not changed after 30 min but significantly after 60 min of PGE1 infusion. Muscular release of most of the amino acids was reduced or shifted to an uptake. The accumulated balance of the amino acids showed a significant increase from -21.9 to +33.2 nmol/100 g x min after 60 min. Thus the infusion of PGE1 led to an inhibition of muscular proteolysis and/or to a stimulation of proteosynthesis. In view of the fact that kinines are released during exercise and are partially effective via prostaglandine liberation, the protein-anabolic effect of exercise might be explained by action of prostaglandins.

Adult↗
PubMed1990

[Indications and results of second-look operation in acute mesenteric vascular occlusion].

In acute mesenteric infarction (AMI) assessment of bowel vitality after surgery remains to be a difficult problem for which second-look-operation was recommended. From 1977-1989, 115 patients were operated on AMI (explor. laparotomy: n = 28, resection and/or revascularization n = 87). In 36/87 patients, a planned second look was performed for control of vitality or lavage. In 10/87 patients, re-resection was performed, of whom 5 patients survived. By the second-look, 6% of 87 patients could be saved. Over all survival was 41.7%.

Abdomen, Acute↗
PubMed1990

[Risk profile and macroangiopathy in type II diabetics in medical practice].

The risk profile and the macro-vascular complications of patients with type II diabetes mellitus (NIDDM) was investigated in general practice patients for the first time in the FRG. It was the aim of the study to evaluate the efficacy of the therapy and possible improvements after detailed instructions in a random sample of well defined NIDDM in the greater Munich area. 290 NIDDM (187 female, 103 male) out of a total of 1500 patients treated by 22 general practitioners were randomly recruited for the study. First results indicated an excess morbidity of the NIDDM, e.g. 43.5% with HbA1c greater than 8%, hypertension in 73.8%, hypertriglyceridemia in 75%, hypercholesterolemia in 36.3% adipositas in 78%, and a micro/macro-albuminuria in 44.5%. A similar risk profile could be determined in cases with recently diagnosed NIDDM. The remarkable risk profile documents itself in the incidence of macro-vascular complications: 40.8% of the male and 43.2% of the female showed a peripheral arterial disease (pAVD), in 8% of all patients a carotid artery stenoses could be detected by means of doppler ultrasound technique; 46.6% of the male and 59.3% of the female patients showed symptoms of CHD. With the exception of the incidence of CHD in patients less than 64 years the duration of NIDDM had no influence on the macro-vascular complications as demonstrated in previous studies. The age however always had a significant influence on all three vascular regions examined. Albuminuria correlated as such with a number of risk factors showed a significant correlation with the incidence of pAVD and occurred more often in males with carotid artery stenoses. Other correlations established were: Hypercholesterolemia and FVIII ass. Ag respectively, and the incidence of carotid artery stenoses; blood pressure, F VIII ass. Ag and pAVD. In the female a negative correlation could be seen between the pAVD and the HDL-level. In patients with CHD sex specific correlations could be determined to blood pressure, HbA1c, c-peptide and triglyceride levels.

Adult↗
PubMed1989

Metabolic effects of prostaglandin E1 on human skeletal muscle with special regard to the amino acid metabolism.

The influence of intra-arterial (i.a.) prostaglandin E1 (PGE1) on the metabolism of amino acids, glucose and free fatty acids in healthy volunteers was determined by means of the forearm technique. The continuous increase of perfusion from baseline 2.9 +/- 0.1 ml/100 g x min to 5.4 +/- 1.5 after 60 minutes of PGE1 infusion, indicates an increase of basal glucose utilisation from 0.51 +/- 0.11 to 2.5 +/- 0.36 mumol/100 g x min via and additional raised glucose extraction rate. Furthermore, PGE1 resulted in a cessation of the basal muscular glycerol production and led to a change from a basal production of free fatty acids to a net absorption into the muscle. This change from an oxidation of free fatty acids to glucose results in an improved energetic gain of 0.72 mol ATP/mol 02. Baseline values showed a release of most amino acids which, after PGE1 decreased significantly or even changed to an intake. The overall balance of all amino acids changed from baseline -27.9 (i.e. release) to +33.2 nmol/100 x min (i.e. intake). This indicates an inhibition of muscular proteolyses and/or a stimulation of protein synthesis under i.a. PGE1. This additional metabolic effect of PGE1 might be an explanation as to why agents with purely vasodilating actions did not prove therapeutically effective in the treatment of peripheral arterial disease in the past.

Alprostadil↗
PubMed1988

[5-year follow-up after endarterectomy of carotid artery thrombosis].

The long-term results of carotid endarterectomy were analysed in 119 patients, operated on between January 1979 and December 1980 (135 endarterectomies; preoperative data analysed retrospectively). 43 patients had been in stage I, 39 in stage IIa, 13 in stage IIb, 4 in stage III, and 20 in stage IV. Perioperative mortality was 0.8%, while hospital mortality was 2.5%. Transitory perioperative neurological deficits occurred in 4.2% of all patients, but no permanent ones. Five years postoperatively 44.5% had died, nearly half (43.4%) of cardiovascular disease. Cerebrovascular disease and tumour each caused 15% of deaths. During the five-year follow-up period 12% of all patients had had transitory ischaemic attacks; 16% had suffered a stroke (in 63% on the operated side). With a high prevalence of risk factors, only the quality of diabetic control (mortality rate of well controlled diabetes 38%, of poorly controlled 70%) and the risk factors heart failure and vascular occlusive disease had a significant influence on the mortality rate. But the mortality rate was significantly lowered with the use of platelet aggregation inhibitors (41.6% vs 72.7%).

Adult↗
PubMed1986

[Local thrombolysis in acute occlusion of a femoropopliteal Gore-Tex bypass].

Occlusion of a femoro-popliteal Gore-Tex-bypass in two patients could be reopened using local low-dose thrombolytic therapy. Apart from the peripheral outflow effective anticoagulation treatment appears to have a deciding influence on long-term results. Application of the thrombolytic selectively to single vessels of the lower leg as well as a post-lysis effect offer the chance for an improvement in outflow. Combination of local lysis with vessel surgery may be an additional alternative for conservation of the extremities.

Acute Disease↗
PubMed1986

Pyruvate attenuation of hypoxia damage in isolated working guinea-pig heart.

Function and various parameters of myocardial substrate and energy metabolism were measured in preload-controlled isolated working guinea-pig hearts perfused with normoxic (95% O2) and hypoxic (30 to 45% O2) Krebs-Henseleit buffers ([Ca2+] = 1.25 mM). Energy-yielding substrates were glucose, pyruvate, lactate, and fatty acids (acetate, octanoate). Hypoxia typically produced an increase in coronary flow but a fall in cardiac oxygen uptake (MVO2); left ventricular pressure and work parameters as well as myocardial high energy phosphate levels were decreased while the releases of adenosine plus inosine (V (Ado + Ino)) and lactate were increased. Extra pyruvate (1 to 5 mM) as compared to physiologic concentrations of pyruvate (0.2 mM) produced a relative stabilization of left ventricular pressure and work parameters combined with an attenuation of V (Ado + Ino) provided 5 to 10 mM glucose was the cosubstrate. Coinfusion of 2-deoxyglucose, a nondegradable hexose, in presence of excess pyruvate as sole substrate was without effects on residual ventricular pump function. When 1 mM lactate plus 5 mM glucose were the substrates, hypoxic heart function was also depressed, V (Ado + Ino) was relatively increased, and post-hypoxic recovery of pressure parameters was impaired. Similarly, the fatty acid substrates tested seemed to adversely affect cardiac performance during hypoxia. Extra pyruvate in presence of glucose induced a fall in hypoxic myocardial lactate and alpha-glycerophosphate contents while cellular citrate reached millimolar levels. Obviously, utilizable amounts of glucose were required for pyruvate stabilization of the high flow hypoxic heart. The beneficial effects of pyruvate appeared to depend on a functioning glycolysis; other effects seemed to include redox-related changes in energy state and/or purine nucleoside metabolism as well as a possible citrate buffering of intracellular Ca2+ load.

Animals↗
PubMed1984

[Effect of ticlopidine on peripheral obliterating arteriopathy].

The efficacy of and tolerance to ticlopidine, a platelet inhibitor, in preventing progression of obliterative arterial disease was compared with that of a placebo in a double-blind and randomized trial in 43 patients (22 on placebo, 21 on ticlopidine) over a period of one year. The course of the disease in both groups was assessed by serial angiography of the lower limbs, both at the beginning and at the end of the study. There was a significantly reduced progression in the ticlopidine group (P less than 0.01). The results support the hypothesis that platelets are of great importance in the progression of arteriosclerosis and that inhibition of platelet function is an effective principle of prevention. Ticlopidine in this respect is an alternative to the use of acetylsalicylic acid.

Angiography↗