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Biomedical subjects

J C Bode

Publications and source records attributed to J C Bode.

At least 55 records · Page 3Linked to original sources
PubMed1994

Parallel determination of gut permeability in man with M(r) 400, M(r) 1500, M(r) 4000 and M(r) 10,000 polyethylene glycol.

Polyethylene glycol has been in use for a number of years for the assessment of gut permeability. The methods so far employed are usually limited to polyethylene glycols in the low relative molecular mass range (up to M(r) 1300). We developed a method for the simultaneous determination of gut permeability to M(r) 400, M(r) 1500, M(r) 4000 and M(r) 10,000 polyethylene glycol, by applying a single oral dose of an appropriate mixture of these polyethylene glycols. After extraction from 24 h-urine, M(r) 1500, M(r) 4000 and M(r) 10,000 polyethylene glycol were quantified by size exclusion chromatography, while M(r) 400 polyethylene glycol was determined by reversed phase chromatography. The detection limit of polyethylene glycol in the relative molecular mass range between M(r) 1500 and M(r) 10,000 was found to be 0.2 mg/l urine, and the detection limit of M(r) 400 polyethylene glycol 5 mg/l urine. Recovery of the polyethylene glycols (N = 6) were 86.6% (CV: 4.8%) for M(r) 400, 94.1% (CV: 7.2%) for M(r) 1500, 97.1% (CV: 5.5%) for M(r) 4000 and 97.4% (CV: 5.6%) for M(r) 10,000. No significant difference was found between the excretion rates in 24 h-urine of M(r) 400 and M(r) 1500 polyethylene glycols in patients with Crohn's disease (M(r) 400: 34.4 +/- 5.5%; M(r) 1500: 5.22 +/- 2.27%; mean +/- SEM, N = 10) and healthy controls (M(r) 400: 33.6 +/- 3.2%, M(r) 1500: 1.09 +/- 0.26%; N = 21). The excretion rate of M(r) 4000 polyethylene glycol was markedly higher in patients with Crohn's disease (0.462 +/- 0.177%) than in healthy controls (0.049 +/- 0.012%, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Alcohol abuse as a cause of illness in an internal medicine department with emphasis on gastroenterology and hepatology].

The percentage and spectrum of alcohol-induced diseases were determined in 200 male and female patients. In 28 percent of the men and 8 percent of the women, inpatient treatment had been necessitated in the first instance by alcohol-induced diseases. In both men and women abusing alcohol, the percentage of younger patients was appreciably higher than in patients who did not abuse alcohol. Among male drinkers, the most common pathologies diagnosed were diseases of the liver (78.6%), the upper gastrointestinal tract, the pancreas (51.7%) and the central nervous system (42%), as well as cardiovascular diseases (23.2%). The majority of male patients abusing alcohol had two or more organic diseases (80%). In 35.4%, three or more different diseases were diagnosed. Among female patients abusing alcohol, the pattern of the various diseases was largely identical with that seen among the male patients. The duration of hospitalisation was appreciably longer in male drinkers (mean +/- SD = 14.1 +/- 10.1 days). Among male drinkers 51.8%, and among female drinkers 68.7%, were also heavy smokers. Of the 144 men in whom alcohol abuse was not certain, 30 were heavy smokers and, in the main, were being treated for cardiac and/or bronchopulmonary diseases. It is highly probable that, owing to the nature of the evaluation employed, the percentages of patients abusing alcohol or nicotine were underestimated. The fact that a high 43% of mainly younger male patients presented with diseases that could be traced back mainly or solely to alcohol or tobacco consumption, together with the multimorbidity and chronicity of the diseases of these patients underscores the urgent need to attach more importance to promoting preventive measures.

Adult↗
PubMed1993

Breath hydrogen excretion in patients with alcoholic liver disease--evidence of small intestinal bacterial overgrowth.

The hydrogen breath test has been used to investigate the incidence of small-bowel bacterial overgrowth in 45 chronic alcoholics and in 60 controls with no history of alcohol abuse. In the group of patients with alcoholic liver disease, the percentage of cases with bacterial overgrowth was almost three times (37.8%) that of controls not abusing alcohol (13.3%; p < 0.001). A separate evaluation of alcoholics with cirrhosis in comparison with those without cirrhosis, revealed no significant difference in the incidence of bacterial overgrowth (42.9% and 33.3%; p > 0.05). Some 16.7% of the controls and 8.9% of the patients with alcoholic liver disease were classified as "non-excreters". Among patients with alcoholic liver disease, the mouth-to-caecum transit time was prolonged by 21.5% in comparison with the controls not abusing alcohol (p < 0.025). The results suggest that bacterial overgrowth might contribute to the functional and/or morphological abnormalities of the small intestine commonly found in patients with chronic alcohol abuse.

Adult↗
PubMed1992

Terlipressin vs. somatostatin in bleeding esophageal varices: a controlled, double-blind study.

Fifty episodes of bleeding from esophageal or gastric varices in 33 patients with cirrhosis were randomized to treatment with either intravenous terlipressin (2 mg initially and 1 mg every 4 hr for 24 hr together with bolus injection and continuous infusion of placebo) or with somatostatin (250 micrograms as a bolus and continuous infusion of 250 micrograms/hr somatostatin for 24 hr and placebo injections). Standard therapy with transfusions, fluid and electrolyte correction and lactulose was administered in both groups. In the terlipressin group, 22 of 25 bleeding episodes (88%) were initially stopped by the vasoactive drugs, and in the somatostatin group 19 of 25 bleeding episodes (76%) were initially stopped by the vasoactive drugs. Two of the three bleeding episodes not arrested by terlipressin and five of the six bleeding episodes not arrested by somatostatin were controlled by balloon tamponade. In one patient in each group variceal bleeding initially could not be stopped, and the patients died. The failure rate of the vasoactive treatment alone, including rebleeding episodes within the study period, was 20% in the terlipressin group and 32% in the somatostatin group. The control rate, including balloon tamponade, was 96% in both groups. The hospital mortality rate was 16% (4 of 25) in the terlipressin group and 24% (6 of 25) in the somatostatin group. Blood transfusions, use of balloon tamponade and duration of bleeding did not differ significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1991

[The localization of colorectal polyps and carcinomas in relation to their size and the histological findings].

Location, size and histological appearance of colorectal neoplasms were examined retrospectively. A total of 1,357 polyps (including small ones, diameter below 0.5 cm) were found in 1,022 of 3,057 coloscopies. The coloscopies were indicated by findings on preceding radiological or endoscopic examinations (48%), occult blood in stool (18%), during follow-up after polypectomy (21%), and after colorectal carcinoma (13%). A single polyp was found in 718 cases (70%), two to four in 221 (26%), more than five in 33 (4%), 1,106 polyps (61%) were found on high coloscopy; 380 of these (38%) were located proximal to the left flexure. Among the 1,230 polyps examined histologically 907 (74%) were adenomas (494 tubular [54%], 379 tubulovillous [42%], 34 villous [4%]). 251 (28%) of the adenomatous polyps and 49 (32%) of the 151 carcinomas were located proximal to the left flexure. The incidence of moderately severe to severe dysplasias increased with increasing diameter of the polyps: 55% of those smaller than 0.5 cm were adenomas. 70% of polyps with a diameter over 1.0 cm were tubulovillous or villous adenomas. The findings confirm that there is a high incidence of polyps proximal to the left flexure. A complete coloscopy should therefore be done as a matter of course.

Age Factors↗
PubMed1991

[Granular-cell tumor of the stomach and esophagus].

A 45-year-old man had for the past four years complained of postprandial feeling of fullness and of left-thoracic pressure sensation. Endoscopy revealed a spherical subcardial tumour, about 3.5 cm diameter, a yellow raised flat 7 x 4 mm tumour in the oesophagus about 44 cm from the upper teeth, and 29 cm from the upper teeth a 4 mm bulge. Forceps biopsy of the subcardial tumour and fine-needle biopsy of the rather larger oesophageal tumour indicated a granular cell tumour. Because of the risk of malignancy the gastric tumour was resected (local excision and fundal plication). The patient has remained without symptoms for 28 months. Follow-up endoscopies have demonstrated that the oesophageal tumours had not grown any further.

Biopsy↗
PubMed1991

Plasma endotoxin concentrations in patients with alcoholic and non-alcoholic liver disease: reevaluation with an improved chromogenic assay.

Plasma endotoxin concentration was measured in 85 patients with alcoholic liver disease (alcoholic cirrhosis (n = 64), alcoholic hepatitis without cirrhosis (n = 11), fatty liver (n = 10), and in patients with non-alcoholic cirrhosis (n = 15]. Endotoxin concentration was determined with an improved chromogenic substrate assay, using individual standard curves for each plasma sample. In patients with alcoholic cirrhosis the mean endotoxin concentration was significantly higher than in patients with non-alcoholic cirrhosis (p less than 0.05). In addition, distinctly higher endotoxin concentrations (greater than 20 pg/ml) were more frequently observed in patients with alcoholic cirrhosis than in non-alcoholic cirrhosis (34.4 vs. 14.3%, p less than 0.05). Mean endotoxin concentration was not significantly higher in cirrhotics with ascites or esophageal varices as compared with the subgroup without ascites or esophageal varices. The endotoxin concentration did not correlate with serum bilirubin, prothrombin concentration or serum enzyme activities. In patients with alcoholic liver disease, however, endotoxin concentration revealed a negative correlation (p less than 0.05) with the concentration of high density lipoprotein cholesterol. On admission endotoxin concentrations in alcoholics with fatty liver were similarly elevated as observed in alcoholic cirrhosis. In six out of 12 patients with fatty liver or alcoholic hepatitis, in whom a second sample of plasma was investigated after 6 to 8 days, endotoxemia was no longer detectable; in the remaining patients, the endotoxin concentration decreased markedly. The results indicate that, irrespective of the stage of liver disease, alcohol abuse favours the development of endotoxemia. They support the hypothesis that gut-derived endotoxins might play a role in the initiation and aggravation of alcohol-induced liver disease.

Adult↗
PubMed1991

High incidence of antibodies to hepatitis C virus in alcoholic cirrhosis: fact or fiction?

An enzyme immunoassay (Ortho-HCV ELISA) for antibodies against the hepatitis C virus was used to test serum samples from 39 patients with alcoholic cirrhosis and 34 patients with alcoholic hepatitis or fatty liver. The frequency of a positive result in the cirrhotics was significantly higher than in the alcoholics without cirrhosis (38.5% vs 8.8%, P less than 0.01). However, the positive results in the cirrhotics were associated with high gammaglobulin concentrations, and optical density values in the assay correlated closely with serum globulin (r = 0.73, P less than 0.01). The findings suggest that serum from patients with alcoholic cirrhosis may contain a component that give false-positive results in the assay.

Biopsy↗
PubMed1991

Effect of omeprazole on nocturnal intragastric pH in cirrhotics with inadequate antisecretory response to ranitidine.

Failure of acid suppression by H2-receptor antagonists has been observed, and recently we have found a higher frequency of patients with inadequate antisecretory response among patients with cirrhosis of the liver. In the present study comprising 16 cirrhotics with inadequate antisecretory response to 300 mg of ranitidine, we tested the effect of 40 mg omeprazole. Nighttime intragastric pH was continuously monitored, and a rise in the intragastric pH above 4.0 for more than 6 h following the oral dose at 18.00 h was considered as response. The median pH profile during the omeprazole treatment was significantly higher than with ranitidine (p less than or equal to 0.001). In contrast to 300 mg ranitidine, which despite sufficient plasma levels 2 and 4 h after intake (762 +/- 431 and 802 +/- 668 ng/ml) resulted in a rise in the nighttime intragastric pH above 4 only for 1.8 +/- 1.7 h, after omeprazole for at least 5 days, the intragastric pH was for 10.1 +/- 2.4 of 12 h above 4 during the night (p less than 0.001). The omeprazole plasma levels were 611 +/- 323 and 881 +/- 533 ng/ml after 2 and 4 h. The data obtained with intragastric pH monitoring indicate that the H+K(+)-ATPase inhibitor omeprazole is able to overcome the H2-blocker resistance in cirrhotics.

Female↗
PubMed1991

Addition of misoprostol to ranitidine in non-responders to H2-blockers and pirenzepine.

In the present study, which comprised 14 patients in whom 300 mg and 900 mg of ranitidine as well as in combination with pirenzepine had failed to suppress acid secretion, we tested the effect of adding misoprostol. Night-time intragastric pH was continuously monitored, a rise in the intragastric pH above 4.0 h more than 6 h following the oral dose at 18.00 h being considered a response. In only 1 of the 7 patients with cirrhosis, and in 1 of the 7 control patients, did the combination of 300 mg ranitidine and 400 micrograms of misoprostol result in sufficient acid suppression. Mean pH profiles during the four study periods were not significantly different and the effect of misoprostol was similar in cirrhotics and controls. The inefficacy of the addition of misoprostol in this selected group of patients who did not respond even high doses of ranitidine (+/- pirenzepine) does not favour the hypothesis that gastric mucosal prostaglandin efficiency may be an important factor in the non-response to H2-receptor antagonists. It appears unlikely that the cause is localized solely at the site of H2-receptors.

Alprostadil↗