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Biomedical subjects

J Adlung

Publications and source records attributed to J Adlung.

At least 37 records · Page 2Linked to original sources
PubMed1977

[Performance and clinical usefulness of the 14CO2-glycocholate-breath-test].

14C-glycocholate breath-tests were performed in 22 clinical patients without gastointestinal disorders, in 11 cases with M. Crohn of the ileum and in 8 patients, in whom an intestinal overgrowth with bacteria was suspected. Additional to the usual discontinuous measurement of the specific activity of 14CO2 the exhaled amount of CO2 and 14CO2 and 14C-serum activity were determined. No advantage was found in the determination of the latter; for 1. discontinuous measurement of the specific activity of 14CO2 was sufficient for detecting disturbed enterohepatic bile-salt circulation; and 2. measurement of 14C-serum-activity or 14C-activity in cholic acids or protein were of no help in differentiating between bacterial overgrowth and diseases of the ileum. There remained doubts regarding the clinical usefulness of the test. Low specificity and many positive tests in patients without corresponding symptoms require that therapeutical procedures in such patients are initiated with some reserve.

Adult↗
PubMed1977

[Insulin resistance and blood glucose replacement rates in liver cirrhosis. Studies with 14C-glucose (author's transl)].

In 21 patients with liver cirrhosis, 35 normal subjects, 8 patients with chemical and 11 with manifest diabetes 0.5 g glucose/kg together with 14C-glucose were injected intravenously. 71% of the cirrhotics showed an impaired glucose tolerance. IRI response was exaggerated. The insulinogenic index was elevated in patients with liver cirrhosis and normal glucose tolerance and normal or subnormal in those with carbohydrate intolerance, as well as in diabetics. Decrease of the specific activity of glucose, expressing supply of non-labelled glucose to the body pool, was much more rapid in patients with carbohydrate intolerance, either hepatogenic or not, when compared at equal glucose concentrations. Moreover all groups with deteriorated glucose tolerance exhaled less 14CO2. Consequently, diabetes in chronic liver disease displays the same abnormalities as diabetes in obesity with respect to liver glucose supply and glucose oxidation. In both conditions diminished glucose assimilation is usually the result of reduced removal and increased supply. Therefore it is concluded that impaired hepatic uptake of glucose cannot be implicated as a single cause of hepatogenic diabetes.

Blood Glucose↗
PubMed1976

[Diagnostics of lactose-malabsorption: value of tolerance tests and 14CO2 exhalation test in patients with and without lactase deficiency (author's transl)].

Lactose-tolerance-test (LTT), ethanol-lactose-tolerance-test (ELTT), 14CO2 breath test and 14C-glucose determination were simultaneously performed in 27 healthy subjects, 16 patients with a Billroth II gastrectomy and 6 patients with a malabsorption syndrome. Intestinal mucosal lactase was absent or significant diminished in 5 of the B II cases and in all patients with malabsorption. In the lactase deficient patients a diminished serum glucose rise after ingestion of 50 g lactose was observed in LTT as well as in ELTT. False positive results in LTT could not be prevented by performing the ELTT. Furthermore the ELTT is not suitable for ambulant investigations because of the required high ethanol load of 0.5 g/kg. Most reliable results were obtained by determination of 14C-serum-glucose after oral application of about 15 muCi of 14C lactose. In respect to lactase level neither false positive nor false negative results were observed. For clinical investigations the procedure of isolation and measurement of 14C-glucose is too laborious however. 14CO2-exhalation test cannot be recommended because of many false positive and false negative results. Moreover 14CO2-exhalation seemed to be insensible and predominant depending on factors other than lactose absorption.

Blood Glucose↗
PubMed1976

[Endoscopic diagnosis of carcinoma in the operated stomach].

In 24 000 gastroscopies at 4 medical departments 705 subjects with gastric operations done more than 5 years before had been studied. 39 of 608 patients with Billroth II, 5 of 81 with Billroth I and 4 out of 15 with gastroenterostomy were found to be suffering from carcinoma of the gastric stump. The primary gastric operations were performed at a medium age of 40 years. The interval between surgery and development of carcinoma averaged 24 years and was shorter in patients operated at a higher age. Besides age and interval since operation risk factors were apparently former gastric ulcers or polyps. Indications for endoscopic follow-up studies of gastrectomized patients to improve surgical results with carcinoma of the gastric stump have been suggested.

Adenocarcinoma↗
PubMed1976

[Studies on pharmacokinetics and biotransformation of ipratropiumbromide in man (author's transl)].

Studies into the human pharmacokinetics of (8r)-3alpha-hydroxy-8-isopropyl-1 alphaH, 5 alphaH-tropanium-bromide- (+/-)-tropate (ipratropium bromide, Sch 1000, Atrovent) following inhalation and oral and i.v. administration are described. The substance was labelled with 14C. The plasma level (total radioactivity) recorded following oral administration was characterised by a low but broad plateau persisting for several hours. After i.v. injection rapid elimination from the plasma was observed in the first phase. The plasma level following inhalation was characterised by an initially rapid absorption and the curve subsequently resembled that following oral administration. An equi-bronchodilatory dose following inhalation produced a blood level 1000 times lower than those following oral dosing. The half-life of elimination lay between 3.2 and 3.8 h for all routes of administration. The maxima were recorded at 3 h. Cumulative renal excretion was 9.3% following oral administration, 72.1% following i.v. route and 3.2% after inhalation. 88.5% were excreted via the faeces following oral dosing, 6.3% following i.v. application and 69.4% after inhalation. Ipratropiumbromide is partly metabolised. After 4 h, the percentage of unchanged substance in relation to total activity in the urine was 24% (oral), 46% (i.v.) and 13% (inhalation). One of eight metabolites-- six in very small amounts-- was identified as N-isopropyl-methyl-nortropiumbromide.

Administration, Oral↗
PubMed1976

[Milk intolerance, lactose intolerance and lactase deficiency in partial resection of the stomach].

Of 40 patients with a partial gastrectomy (Billroth-II) 10 developed a milk intolerance and 11 had a lactase deficiency, the latter in 4 cases appearing together with a decrease in other disaccharidases. Only 2 of the 11 lactase-deficient patients complained of milk intolerance. The Ethanol lactose tolerance test (ELTT) was performed in 21 patients and was found to be abnormal in 6. Whereas cases of abnormal ELTT usually (4 of 6 cases) showed a lactase deficiency, only 2 patients with milk intolerance showed an abnormal ELTT and lactase deficiency. Milk intolerance can therefore only exceptionally be explained by lactase deficiency, and lack of lactase in the upper jejunum usually does not produce intolerance symptoms. Moreover, in comparable determinations from the afferent and efferent jejunal loop no differences in enzyme activities could be observed.

Adult↗
PubMed1976

[14CO2 exhalation tests. Diagnostic improvement in gastroenterologic diseases].

For evaluation of 14CO2-breath-tests the three most employed tests, namely glycero-14C-tripalmitate-test, 14C-lactose-tolerance-test, and 14C-glycin-cholate-test, were performed in healthy volunteers (n = 69), patients with chronic pancreatitis (n = 18), manifest malassimilation (n = 8), lactase deficiency (n = 15), and patients, in whom a disturbed enterohepatic bile salt circulation was suspected (n = 19). Usefulness of malabsorption tests was limited by many false normal results. Cholylglycin-breath-test on the other hand was sensitive, but clinical significance remained questionable. In our opinion simple performance and lacking discomfort are no sufficient arguments for 14CO2-breath-test.

Carbon Dioxide↗
PubMed1975

[New procedure in the diagnosis of maldigestion. Studies with 3-H palmitic acid and 14-C tripalmitate in normal subjects and patients with chronic pancreatitis].

3H-palmitic acid and 14C-tripalmitate dissolved in 1.0 g indian corn oil/kg body weight were administered to 29 patients with chronic pancreatitis and 25 control subjects. For the following 8 h 3H and 14C radioactivity in serum lipids and 14CO2 in expired air were measured at 2-hour intervals. Triglyceride absorption was significantly lowered in the pancreatitis group, while the wide dispersion in healthy subjects precluded reliable information on 14C-triglyceride absorption alone in individual cases. When related to palmitic acid absorption, however, reduced triglyceride absorption was much more evident and could be clearly demonstrated in 21 of the 29 patients with chronic pancreatitis. Since none of them had severe pancreatic insufficiency, the new double isotope method presented here appears to offer a very sensitive means of detecting maldigestion or slowed triglyceride hydrolysis. Compared with the 3H-fatty acid absorption, a relatively reduced triglyceride absorption was found in many cases without steatorrhea or otherwise demonstrable pancreatic insufficiency. Additional measurement of 14CO2 appears to be worthless, since in our patients specific activity of 14CO2 in the expired air was not reduced even in cases with mild steatorrhea.

Adult↗