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Biomedical subjects

L Degen

Publications and source records attributed to L Degen.

At least 19 recordsLinked to original sources
PubMed2002

Subjective and functional results after replacement of the stomach with an ileocecal segment: a prospective study of 20 patients.

BACKGROUND AND AIMS: The optimal reconstruction procedure after gastrectomy is still a matter of debate. The ileocecal interpositional graft offers an excellent reservoir capacity, the preservation of duodenal passage, and a natural antireflux barrier (ileocecal sphincter). PATIENTS AND METHODS: We prospectively analyzed the quality-of-life outcome in 20 patients undergoing ileocecal interpositional graft (13 subdiaphragmatic reconstruction, 7 intrathoracic reconstruction) after gastrectomy in a University Hospital and a Canton Hospital (mean follow-up 6 months), operative and postoperative morbidity, body weight, reflux, and dumping symptoms. In a smaller series of nine patients we performed functional tests such as gastric emptying measurements, glucose tolerance tests, and manometry of the gastric substitute. RESULTS: The mean gastrointestinal quality-of-life index in the subdiaphragmatic reconstruction group 114, and that in the intrathoracic reconstruction group was 106. Mild reflux and dumping symptoms were noted by no patients in the former group and by two of seven patients in the latter. In the smaller series of nine patients gastric emptying time was faster in the intrathoracic group, but no difference in plasma glucose level was found between the two groups. CONCLUSIONS: Reconstruction after gastrectomy with an ileocecal interpositional graft achieves good quality of life with an acceptable morbidity. The technique seems to reduce the occurrence of postoperative reflux and dumping symptoms.

Anastomosis, Roux-en-Y↗
PubMed2002

Role of thyrotrophin releasing hormone and corticotrophin releasing factor in stress related alterations of gastrointestinal motor function.

There is a growing body of experimental and clinical evidence to indicate that stress influences gastrointestinal motility. The most common pattern of gastrointestinal motor alterations induced by a variety of different stress factors is that of delayed gastric emptying and accelerated colonic transit. Central administration of corticotrophin releasing factor mimics both of these effects. This review focuses on the effects of two centrally acting peptides known to influence gastrointestinal motility and transit in experimental animals: thyrotrophin releasing hormone and corticotrophin releasing factor. The biological actions of these peptides are discussed in relation to the motility changes and pathways involved in their actions.

Animals↗
PubMed2001

The effect of cholecystokinin in controlling appetite and food intake in humans.

The present review of the satiating effect of cholecystokinin in humans has revealed that cholecystokinin is a physiological satiety factor in humans. The results demonstrate the efficacy of the satiating actions of exogenous and endogenous CCK in humans. The therapeutic potential of CCK analogues cannot be estimated until further studies are performed that demonstrate the efficacy of CCK analogues for decreasing body weight, and the safety of CCK when administered repetitively for prolonged periods.

Animals↗
PubMed2001

[Diagnostic procedures in esophageal diseases].

The algorithms for diagnosis of esophageal diseases largely depend on the patient's symptoms. The most important diagnostic procedure is flexible upper gastrointestinal endoscopy which allows inspection and assessment of the entire esophagus with the possibility to take biopsies for histological examination. Radiographic tests are indicated for special indications only. Finally, the role of functional tests (manometry, 24-hour pH-metry) and their indications are discussed.

Barium Compounds↗
PubMed2001

Tegaserod, a 5-HT4 receptor partial agonist, accelerates gastric emptying and gastrointestinal transit in healthy male subjects.

BACKGROUND: Serotonin and its type-4 (5-hydroxytryptamine4) receptor play a major role in the physiology of the gastrointestinal tract. The effect of intravenous and/or oral tegaserod, a 5-hydroxytryptamine4 receptor partial agonist, on gastric emptying, small bowel transit and colonic transit has not been studied in detail in humans. AIM: To assess the pharmacodynamic effects of repeated oral and intravenous administration of tegaserod on gastric emptying and small intestine and colonic transit. METHODS: A randomized, placebo-controlled, double-blind, three-way, crossover study of 6 mg oral and 0.6 mg intravenous tegaserod in 12 healthy male subjects was performed. Each treatment arm of the study involved 3 days of twice-daily administration and 1 day of daily administration of the study drugs. RESULTS: In comparison with placebo, oral and intravenous tegaserod significantly increased the gastric emptying rate (P < 0.01), accelerated colonic filling (P < 0.01) and shortened colonic transit at 48 h (P < 0.05). Tegaserod shortened the small intestine transit time by 30% after oral and by 37% after intravenous administration. CONCLUSIONS: In healthy subjects, tegaserod markedly accelerated gastric emptying and small intestinal transit, and induced a small but significant acceleration of colonic transit. Tegaserod can act as a promotile agent throughout the gastrointestinal tract.

Administration, Oral↗
PubMed2001

Loxiglumide, a CCK-A receptor antagonist, stimulates calorie intake and hunger feelings in humans.

Exogenous cholecystokinin (CCK) induces early satiety when infused into humans. Whether alimentary CCK (CCK-A) receptor blockade stimulates food intake in humans is, however, uncertain. The aim of the present investigation was, therefore, to establish the effect of CCK-A receptor blockade on satiety and eating behavior in healthy volunteers. To further explore the role of endogenous CCK, the effects of the specific CCK-A receptor antagonist loxiglumide (Lox; 22 micromol. kg(-1). h(-1)) on satiety and eating behavior were investigated in healthy men and compared with saline infusions (as placebo) in a series of randomized, double-blind, placebo-controlled, crossover studies. Lox produced a slight (7%), but not significant (P = 0.104), increase in food intake that was accompanied by a modest (10%), but significant (P < 0.004), increase in calorie intake. Fluid ingestion was not affected by Lox. Subjects experienced more hunger and delayed fullness during Lox infusion than during saline infusion (P < 0.05). This study provides further evidence that CCK is an endogenous physiological satiety signal acting through CCK-A receptor-mediated mechanisms. Repeated-dose studies comparing hunger and satiety responses after CCK-A receptor blockade in healthy subjects and patients with eating disorders may help clarify the possible involvement of endogenous CCK in these conditions.

Adult↗
PubMed2000

The role of long chain fatty acids in regulating food intake and cholecystokinin release in humans.

BACKGROUND AND AIMS: The mechanism of intraduodenal fat induced inhibition of food intake is still unclear. Therefore, we tested the ability of duodenal fatty acids to suppress food intake at a lunchtime meal; in addition, we were interested to test if these effects were mediated by cholecystokinin (CCK) A receptors. SUBJECTS AND METHODS: Three sequential double blind, three period crossover studies were performed in 12 healthy males each: (1) subjects received intraduodenal fat with or without 120 mg of tetrahydrolipstatin, an inhibitor of gastrointestinal lipases, or saline; (2) volunteers received intraduodenal long chain fatty acids, medium chain fatty acids, or saline; (3) subjects received long chain fatty acids or saline together with concomitant intravenous infusions of saline or loxiglumide, a specific CCK-A receptor antagonist. The effect of these treatments on food intake and feelings of hunger was quantified. RESULTS: Intraduodenal fat perfusion significantly (p<0.05) reduced calorie intake. Inhibition of fat hydrolysis abolished this effect. Only long chain fatty acids significantly (p<0.05) decreased calorie intake, whereas medium chain fatty acids were ineffective. Infusion of loxiglumide abolished the effect of long chain fatty acids. CONCLUSIONS: Generation of long chain fatty acids through hydrolysis of fat is a critical step for fat induced inhibition of food intake; the signal is mediated via CCK-A receptors.

Adult↗
PubMed1999

The role of octreotide in the treatment of gastroenteropancreatic endocrine tumors.

Gastrointestinal-endocrine pancreatic (GEP) tumors are rare, occurring in less than 1% of the population. They are usually divided into functionally active or nonfunctioning tumors. Functionally active tumors produce a variety of substances (mainly peptides or serotonin). The tumors are classified according to the dominant clinical syndrome that they cause. Surgery is the treatment of choice in patients with GEP tumors and it should always be considered, even if total tumor excision cannot be achieved. Reduction in tumor mass (debulking) may improve the patients symptoms. Medical treatment is used in patients with advanced malignant endocrine tumors. The most important compounds to control symptoms in these patients are somatostatin analogues. Natural somatostatin is produced in different molecular forms and has inhibitory effects on a number of functions. The observation of potent inhibitory effects on various hormone-secreting cells led to the use of somatostatin for symptomatic treatment of peptide-secreting tumors. Natural somatostatin is not suitable for long-term clinical application; therefore, synthetic somatostatin analogues were developed with improved pharmacokinetic characteristics. The best characterized analogue, octreotide, has been successfully applied to patients with functioning GEP tumors. Octreotide can dramatically ameliorate the debilitating symptoms of patients suffering from the clinical manifestations of endocrine tumors such as diarrhea and flushing. The success of octreotide therapy is best reflected in terms of its impact on the patient's quality of life as defined by the activity to perform normal daily activities.

Antineoplastic Agents, Hormonal↗
PubMed1998

[Ileo-cecal segment as stomach substitute].

In clinical practice a long Roux-en-Y reconstruction is most often used for gastric replacement. Among various postgastrectomy symptoms, alcaline reflux is the most disturbing. A great variety of different pouch reconstructions with or without duodenal bypass only control reflux in part. The ileocoecal interposition has been placed between the oesophagus and the duodenum as a gastric substitute in 14 patients without postoperative mortality. This preliminary series demonstrates an excellent control of alcaline reflux and a good quality of life, according to the Eypasch score. Dysphagia or stasis in the distal oesophagus are absent as is gas bloating. This type of reconstruction, which is simpler than some of the pouch reconstructions, probably deserves more attention and may perhaps be perfected by varying the length of ileum and volume of ascending colon to be interposed.

Cecum↗
PubMed1997

Preoperative approach to rectal carcinoma.

The preoperative evaluation of patients with rectal carcinoma requires a careful medical history with close attention to symptoms. After a thorough physical examination including digital examination of the rectum, a proctoscopy reveals the size and localisation of the tumour. Even if a neoplasm has been documented by this procedure, total colonoscopy should be performed to detect synchronous neoplastic lesions at other sites in the colon which may affect the surgical resection. Endosonography is recommended as an additional diagnostic step because it allows a precise, preoperative staging of the tumour. Abdominal ultrasound or, alternatively, CT scan of the abdomen, is necessary to exclude hepatic metastases.

Algorithms↗
PubMed1997

[Irritable colon].

Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder, defined as a variable combination of chronic or recurrent gastrointestinal symptoms not explained by structural or biochemical abnormalities. It is attributable to the intestine with symptoms of abdominal pain, altered bowel habits and bloating. The diagnosis is primarily based on typical symptoms and prudent use of investigations to exclude organic disorders. The initial positive diagnosis is accurate and on a longterm follow-up its revision rarely required. A change in its clinical manifestation may imply the superimposition of another disorder. Treatment primarily rely on the confidence in the diagnosis and a strong physician-patient relationship. High fiber diets and bulking agents may be effective in alleviating symptoms. Though antispasmodic, antidiarrheal and psychotropic drugs are repeatedly used in patients with moderate to severe symptoms their effects remain uncertain. Psychotherapy, hypnosis and biofeedback may relief symptoms and may be considered for motivated patients with moderate to severe symptoms.

Colonic Diseases, Functional↗
PubMed1976

Microbial degradation of oil spills enhanced by a slow-release fertilizer.

The improved cleanup of marine oil spills by stimulating biodegradation through the use of a slow-release fertilizer is reported. A paraffin-supported fertilizer containing MgNH4PO4 as active ingredient was developed and evaluated in laboratory and field experiments using quantitative infrared spectrometry and chromatographic techniques. The biodegradation of Sarir crude oil in the sea was considerably enhanced by paraffin-supported fertilizer. After 21 days 63% had disappeared as compared to 40% in the control area.

Bacteria↗