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Biomedical subjects

K U Schentke

Publications and source records attributed to K U Schentke.

18 recordsLinked to original sources
PubMed1991

[The effect of various non-ulcer pharmaceuticals on nocturnal gastric pH in healthy subjects].

The effects of 4 non-ulcer drugs and the M1-antagonist pirenzepine on the nocturnal intragastric pH were investigated in 12 healthy volunteers. We tested single doses of pirenzepine (100 mg), Chlorprothixene (30 mg), clonidine (75 micrograms), ketotifen (3 mg) and nifedipine (30 mg) in an randomized, single-blind, cross-over study. The nocturnal intraluminal pH is significantly elevated not only by pirenzepine but also by the other substances. As expected pirenzepine (mean nocturnal pH = 2.49 +/- 0.22) shows the most distinct effect, nifedipine (mean nocturnal pH = 1.72 +/- 0.20) the most sparsely effect. The other drugs are nearly half as effective as pirenzepine. The acid suppressive side effect of the non-ulcer remedies is considered to be important for the treatment of ulcer patients with concomitant diseases.

Adult↗
PubMed1991

[Ultrasonography studies on spontaneous and pharmacologically modified gallbladder motility].

The intra- and interindividual variations of gallbladder motility were sonographically studied in 10 healthy subjects. We investigated the following criteria: a) the gallbladder volumes after overnight fasting on 5 consecutive days, b) the spontaneous motility under fasting over 12 or 24h at hourly intervals, c) the emptying rate and time of maximal contraction after stimulation with sorbitol, and d) the emptying rate and time (like c) after premedication with "cholagogic" drugs (Cholecysmon, Divalol), nifedipine, indomethacin or N-butylscopolaminiumbromide. We found a great intrapersonal and interpersonal variability in gallbladder volumes after overnight fasting in consecutive days. In subjects fasting over 24h phases of dilatation with maxima at 12 AM and 4 PM alternated with phases of contraction with maxima at 8 AM and 4 PM. After premedication with nifedipine, indomethacin and N-butylscopolaminiumbromide a significant decrease of the emptying rate was observed. The time of maximal contraction did not differ however. After premedication we found a distinct intra- and interindividual variability too. Cautious interpretation of gallbladder motility studies is necessary.

Adult↗
PubMed1991

[Lipid metabolism disorders in primary biliary cirrhosis (PBC)].

40 women, average age 52.5 years, with varying stages of primary biliary cirrhosis, were observed. One third of them suffered from a mild anaemia, mean plasma concentrations of ALAT were increased four times and those of AP six times. Despite the hepatocellular damage products of the liver synthesis such as transport proteins or coagulation factors were found to be normal or enhanced. 60% of the patients had a hypercholesterolaemia. The risk factors low density lipoprotein (LDL)- and very low density lipoprotein (VLDL)-cholesterol showed normal levels, but the protective factor high density lipoprotein (HDL)-cholesterol was clearly increased. Apart from the low blood pressure in most of the patients and the absence of other risk factors these observations explain, why patients with PBC and hypercholesterolaemia don't usually develop arteriosclerotic complications. Only in case of severe cholestasis a lipid constellation comes into being accompanied by high risk for the blood vessels, but in these cases the terminal stage of PBC limits the survival. Positive correlations between markers of cholestasis and lipid parameters let an enhanced production and simultaneous impaired excretion of cholesterol be assumed.

Adult↗
PubMed1991

[The significance of internal medicine intensive care within the complex of intensive medicine. Discussion contribution to the structural and professional classification in adult intensive medicine].

The development and establishment of intensive care units for adult patients requires a far-reaching subdivision into surgical and conservatively oriented intensive care for qualitative and quantitative reasons. Insufficiently substantiated claims to monopolization of intensive care techniques that are polemically asserted have to be strongly contradicted. The present paper is concerned with approved structural concepts of intensive care developed by Deutsche Krankenhausgesellschaft and various medical societies. They are supplemented by personal experience in the field of internal intensive care.

Adult↗
PubMed1990

Prophylactic endoscopic sclerotherapy of esophageal varices--a prospective randomized trial.

Sixty-three patients with degree III or IV esophageal varices and the so-called red color sign, but without previous bleeding were randomly assigned to either prophylactic sclerotherapy (PST) (n = 30) or to a control group (n = 33). In 58 cases the portal hypertension was caused by liver cirrhosis (40% alcoholics). The two groups were comparable with respect to demographic data and endoscopic appearance, causes and severity of liver damage. Sclerotherapy was performed as combined intra-and paravariceal injections of 2 or 3% polidocanol. All patients, both in the treatment and in the control groups, who bled from varices after randomization, received sclerotherapy until the varices were eradicated, and remained in their groups. After a mean follow-up of 44.5 months, the bleeding rate in the PST group was significantly lower (30% vs 75%, p less than 0.01). The difference became significant from the second year onward. Fourteen patients of the PST group and 19 of the controls died (4 and 14, respectively, p less than 0.05 as a result of the bleeding). Life table analysis (Kaplan-Meier) revealed no differences in survival between the two groups. At the present time PST cannot yet be recommended as a method for clinical routine use.

Adult↗
PubMed1990

[Drug-induced liver damage from the clinical viewpoint].

Extensive drug-induced hepatic injury leading up to jaundice occurs relatively rarely. Generally it is not predictable, independent on dosage and irreproductible in animals. As a rule you find it in less than 0.1% of the patients taking the drug, whereas the degree may range up to heavy or lethal (e.g. for isoniazid, methyldopa, halothane). Pathogenetically reactive metabolites capable of producing cytotoxic and/or immune reactions may play a role. Obviously higher age, female sex and endogenous or exogenous alterations in hepatocellular drug metabolism are disposing factors. Drugs, to which our patients most frequently reacted, were dihydralazine alone or in combination with propranolol, and ketophenylbutazone. The lymphocyte transformation test proved diagnostically valuable although it cannot be considered to represent a generally reliable testing method for drug-induced liver disease. Clinical, laboratory and histological findings are typical with a wider range of drugs, but liver biopsy provides the most reliable criteria. Clinical suspicion and stopping the intake of potentially noxious drugs are of importance. The reexposition test should be reserved to exceptional cases.

Chemical and Drug Induced Liver Injury↗
PubMed1979

[Comparative study on the diagnostic value of direct and indirect cholangiography].

The examinations contain the findings of the endoscopic retrograde cholangiopancreaticography in 600 patients, the date of a controlled comparative study intravenous cholangiotomography versus endoscopic retrograde cholangiography in 45 patients undergoing endoscopic retrograde cholangiopancreaticography and the results of the percutaneous transhepatic cholangiography in 54 patients. In anicteric patients and after subsidence of the clinical symptoms the optimum use of the intravenous cholegraphy with tomography is to be demanded. It is able multiply to clarify the diagnosis. The terminal part of the choledochus deserves particular consideration. In obstructive jaundice the percutaneous transhepatic cholangiography is essentially more successful and simpler than the endoscopic retrograde cholangiography.

Biliary Tract Diseases↗
PubMed1978

[Diagnosis of extrahepatic biliary tract obstruction and constriction via direct cholangiography].

The diagnostic potentialities in cholestasis and cholangitis could be considerably improved by endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatal cholangiography (PTC) with a thin needle (0.7 mm). First ERCP was performed, enabling us to establish pathological findings in 62 per cent of the 233 examinations in the period 1975--1977. Gallstones were most often found-in 65 cases (28%). Second to be found was the suptapapillary stenosis of the bile ducts and obstruction of the bile ducts--42 cases (18% of the examined), caused by surgical interventions, tumours of the bile ducts and processes in the region of the head of the pancreas. When ERCP fails to provide sufficient data or is ineffective - PTC is performed. Correct diagnosis was made in 15 cases out of 23 examinations, in six - partial data were obtained and in two - the examination failed.

Biliary Tract Diseases↗
PubMed1976

[Laparoscopy--current aspects].

A short survey is given on description and evaluation of progress and developmental trend of laparoscopy. Important technical improvements are the cold light via the glass fibre light conductor, optics of high value, the colour photography with electronic flash-light, colour films and colour television, new accessory instruments and belongings. Now as ever hepatomegaly and splenomegaly, jaundice, ascites, portal hypertension, suspicion of cirrhosis and metastases are regarded as main indications. The laparoscopy deserves a greater consideration in unclear abdominal symptoms, in gynaecological diseases, for the proof of the affection of liver and spleen in lymphogranulomatosis, sarcoidosis, tuberculosis (with aimed liver biopsy). The endoscopic retrograde cholangiopancreatography in the differential diagnosis of the jaundice competes with the laparoscopy, but it is not able to supersede it. The laparoscopic judgment of the pancreas and the importance of visible changes of the fine structed. Among the contraindications of the laparoscopy the hiatal hernia has lost its significance.

Abdomen, Acute↗