PubMed Health⌕ Search

Biomedical subjects

K H Holtermüller

Publications and source records attributed to K H Holtermüller.

At least 55 records · Page 3Linked to original sources
PubMed1980

Regulation of pancreatic and gallbladder function by absorption of intrajejunal phenylalanine in man.

The effects of varying loads of intraduodenal phenylalanine on pancreatic and gallbladder function were investigated in 32 healthy volunteers using a triple lumen perfusion system. L-phenylalanine absorption rates in the proximal jejunum were measured simultaneously. Intraduodenal L-phenylalanine produced a dose related increase in pancreatic secretion reaching the maximum at the concentration of 100 mM. Bilirubin outputs too increased significantly but did not parallel enzyme secretion. In contrast to the effect of L-phenylalanine, D-phenylalanine 50 mM did not stimulate pancreatic enzyme secretion and gallbladder emptying. The absorption rates of L-phenylalanine increased with rising luminal concentrations. There was a significant correlation between pancreatic secretion and L-phenylalanine absorption rates. This relationship suggests that the release of cholecystokinin, a hormone stimulating pancreatic and biliary function is dependant of the absorption of nutrients like amino acids.

Adult↗
PubMed1980

Gallstone dissolution with chenodeoxycholic acid. A clinical study.

Out of 95 patients with radiolucent gallstones who enrolled in a clinical study with chenodeoxycholic acid (CDC) for gallstone dissolution 75 patients with cholecystolithiasis completed 12 months of treatment. As a side effect 31% of patients reported intermittent diarrhea which did not cause cessation of therapy or missing of work. The incidence of biliary colic was markedly decreased during treatment in comparison to the rate in the year before. From more than 20 laboratory values checked before start and every 3 months during therapy only aminotransferases increased up to 3 fold in 20% of patients. gamma-GT elevated in 31% of patients before treatment improved in half of these patients during therapy. Gallstone dissolution defined as 30% or more diminution of the gallstone area on comparable x-rays occurred in 40% of patients. Analysis of factors showed that gallstones above 2 cm in diameter did not dissolve. When the dose of CDC was retrospectively related to body weight a success rate of 68% was found in the group taking more than 13 mg CDC/kg/day. The lithogenic index determined at 6 and 12 months had significantly decreased after 6 months in patients with success. This study demonstrates that medical dissolution of gallstones with chenodeoxycholic acid should be performed in patients with radiolucent stones of less than 2 cm in diameter and with a dose above 13 mg CDC/kg body weight/day. Under these conditions the success rate is above 60% accompanied by minimal side effects.

Adolescent↗
PubMed1980

[Massive upper gastrointestinal bleeding as first clinical manifestation of pseudoxanthoma elasticum (author's transl)].

We describe a patient with a "cryptogenic" massive upper gastrointestinal bleeding due to a pseudoxanthoma elasticum, recognized only postoperatively. She underwent twice emergency abdominal surgery with total gastrectomy and partial jejunal resection, with a complicated postoperative course. An insufficient enteral anastomosis was perhaps caused by deficient reapir mechanisms of the involved organs due to the underlying disease. Pseudoxanthoma elasticum, an hereditary degenerative disease of especially the elastic connective tissue, involves primarily the vascular system, skin, and eyes, with the typical complication of massive gastrointestinal bleedings. Instead of surgical intervention, such bleedings should be treated preferably by utmost application of conservative means.

Adult↗
PubMed1980

[Ultrasonic diagnosis and control of an amebic obscess of the liver (author's transl)].

A case report is given of a patient, who suffered from relapsing fever, loss of weight, and right-sided upper abdominal colicky pain. A tentative diagnosis of amebic abscess was established on clinical grounds and after ultrasonography. Metronidazol was given and body temperature normalized within 24 hours; 6 weeks later only scarring of the liver remained. Sonographic controls were performed once weekly during the course of the disease, showing that the central parts of the abscess were liquified increasingly; at the same time a marginal zone about 1 cm broad was formed. This type of marginal zone could be demonstrated in another patient with amebic abscess of the liver as well by ultrasonography, whereas it could never be shown in patients with purulant abscesses of the liver.

Adult↗
PubMed1980

[Complicated ulcer; prevention and therapy of upper gastrointestinal bleeding; indications for antacid therapy].

Antacids reduce gastric acidity by neutralization, diminish peptic activity by increasing luminal pH above that optimal for proteolysis and provide thereby the rational for their use in ulcer disease. In clinical trials antacids fastened ulcer healing in patients with duodenal ulcer but not with gastric ulcer when compared to placebo. Furthermore, the prophylactic use of antacid medication can significantly reduce the frequency of acute bleeding when gastric content is titrated to a pH greater 3.5 on an hourly basis. Cimetidine does not adequately protect seriously ill patients from acute upper gastrointestinal tract bleeding. Antacids are better for this purpose. So far the efficacy of an antacid therapy has not been proven in controlled trials in patients with chronic ulcer disease, in patients with recurring ulcers following gastric surgery and in patients bleeding from acute or chronic gastroduodenal lesions.

Antacids↗
PubMed1979

[Therapy with antacids].

The usefulness of antacids in peptic ulcer disease is based on their ability to neutralize secreted gastric acid and to inhibit pepsin activity. The neutralizing capacity (expressed as mval of neutralized hydrochloric acid at a given pH) of different antacids depends upon their chemical composition. To achieve adequate neutralization of stimulated gastric acid secretion antacids have to be taken one and three hours after a meal in a dosage neutralizing 40-80 mval of acid. So far antacids have not been shown to be more effective in relieving ulcer symptoms than placebo. On the contrary an adequate antacid regimen will promote the healing of both gastric and duodenal ulcers in outpatients. Furthermore antacid prophylaxis will reduce the occurrence of acute gastrointestinal bleeding in critically ill patients.

Aluminum Hydroxide↗
PubMed1976

[Behavior of gastrin, renin, aldosterone and electrolytes after administration of deglycyrrhizinized liquorice and carbenoxolone in healthy subjects].

We found that renin and aldosterone values do not drop except when administering Carbenoxolone. The significant rise of sodium (11) in the serum and the drop of the serum-potassium values are probably responsible for the undesirable Carbenoxolone side effects; they occur following the administration of deglycyrrhizinized succus. The rise of post-prandial gastrin in the serum of the above as compared to the values obtained from untreated controls is common to both.

Adult↗