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Biomedical subjects

M Rehner

Publications and source records attributed to M Rehner.

At least 19 recordsLinked to original sources
PubMed1997

[Endoscopic prosthesis implantation in stenoses and fistulas of the proximal cervical esophagus].

Endoscopic placement of an esophageal prosthesis is a well established palliative treatment for esophageal carcinoma. However, the treatment of high cervical tumors using commercially available plastic prostheses is problematic. We modified the design and implantation techniques of the Celestin prosthesis to accommodate high cervical tumors and report our results in 38 patients. Over a 7 year period 42 modified Celestin prostheses were implanted in 38 patients with high cervical esophageal tumors. 15 had stenosis only, 22 had a stenosis and fistula, and one had a fistula without stenosis. Graduated bouginage up to 38 Fr or 42 Fr for large prostheses was performed prior to stent placement in an average of 2.3 sessions. There were no procedure-related complications. Only in one case the prosthesis had to be withdrawn after reimplantation because of intolerable painful foreign body sensation. Improvement of dysphagia was achieved in 34 patients. The fistulas could be adequately bridged and sealed in 17 of 23 patients. Prostheses migrated in 11 cases (proximally, n = 6; distally, n = 5). Mean patient survival in 28 patients followed until death was 86 days (range 5-338 days).

Adult↗
PubMed1995

Comparison of pantoprazole versus omeprazole in the treatment of acute duodenal ulceration--a multicentre study.

METHODS: In this randomized, double-blind, multicentre study, the proton pump inhibitors pantoprazole and omeprazole were compared in patients with active duodenal ulcers. Two hundred and seventy-six protocol-correct patients received either pantoprazole 40 mg (n = 185) or omeprazole 20 mg (n = 91), once daily for 2 or 4 weeks, depending on the progress of ulcer healing. RESULTS: Rates of complete ulcer healing after 2 weeks were 71% in patients given pantoprazole and 74% in patients given omeprazole. After 4 weeks the figures were 96% and 91%, respectively. These differences were not significant. There was no significant difference in ulcer pain prior to treatment, and 85% of the pantoprazole group and 86% on omeprazole were pain-free after 2 weeks (not significant). The time until complete pain relief with pantoprazole or omeprazole, based on data from diary cards, was not significantly different (P > 0.05, Uleman's U-test). Both treatments were equally well tolerated. Changes in routine laboratory parameters were minimal in both groups. CONCLUSION: Pantoprazole was shown to be a highly-effective and well-tolerated treatment for acute duodenal ulcer. Pantoprazole 40 mg and omeprazole 20 mg were equally effective with respect to ulcer healing and pain relief, and have similar adverse event profiles.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1995

[Occlusive jaundiced caused by liver metastases. Results of endoscopic surgical treatment].

The results of endoscopic drainage treatment in 69 patients with metastases of the liver have been analyzed for the period from 1982 to 1992. Fifty-five patients had follow-up. Criteria for inclusion were: positive diagnosis of liver metastases, jaundice, and primary origin of tumors distant from the pancreaticobiliary system ("distant" primary). Localisations of metastic obstructions were: hilum of the liver (n = 24), commonbile duct (n = 16), and prepapillary region (n = 15). Treatment was performed by transpapillary applications of one or more (n = 3) pig-tail or Tannenbaum stents. Concentrations of mean serum bilirubin could be reduced from 14.5% to 8.8 mg%, 16 patients reached a normal level (less than 1.0 mg%). The median survival time was 76 days ranging vom 4 to 299 days. The most frequent complication was cholangitis in 29% of the cases with mortality in 6 patients. Patients less than 60 years of age and with obstructions in the mid commonbile duct gained most by this kind of treatment. Results were poor in elderly patients with hilar stenosis. Selected patients with known liver metastases may benefit from endoscopic treatment of jaundice.

Adult↗
PubMed1994

A review of treatment of duodenal and gastric ulcers--pantoprazole vs. omeprazole.

The efficacy and safety of pantoprazole in the treatment of duodenal and gastric ulcers has been compared with that of the first proton pump inhibitor omeprazole in two (previously reported) clinical studies. Pantoprazole (40 mg/day) administered orally was an effective and well-tolerated treatment for both indications. Pantoprazole was as effective as omeprazole (20 mg/day) and had a similar safety profile. For gastric ulcers, the healing rate with pantoprazole was superior to that with omeprazole at 4 weeks.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1990

[Differential after care for early detection of recurrence--from the general practice viewpoint].

A field-research on follow-up of GI-Carcinoma in 1989 with contributions of 159 general practitioners and physicians of Hamburg city area revealed some specific problems in performance and quality: lack of communications by and insufficient and inconstant qualifications of involved hospital staff as well as high rate of deficits in knowledge of necessary systematic examinations in symptom free patients.

Aftercare↗
PubMed1989

[Cancer surgery--palliative surgery?].

Results of surgical treatments in carcinomas of solid organs are presenting a constant pour level of success. Radical treatment as final intention of tumor management cannot be performed in the majorities of cases. We suppose that advances can be expected only by new structural approaches to surgical performance. Cooperation with clinical pathologists, oncologists and immunologists must be organized on a new level. This means also increased work concerning typing, grading, staging, documentation and follow-up. Surgeons should develop as competent partners for this cooperation to regain their central position in oncologic network of the future.

Humans↗
PubMed1986

[Different healing tendencies of reflux esophagitis following omeprazole and ranitidine. Results of a German-Austrian-Swiss multicenter study].

The effectiveness of a single, morning oral dose of 40 mg omeprazole or a twice daily oral dose of 150 mg ranitidine was compared in a randomized endoscopically controlled double-blind trial at 37 clinics in Austria, Germany and Switzerland. A total of 178 out-patients in stages I-IVa (after Savary and Miller) were entered into the trial: 78 in stage I, 60 in stage II, 27 in stage III, and in 13 in stage IVa. As early as at the end of the third treatment week there was a significantly higher rate of complete healing or reduction into a lower stage with omeprazole than ranitidine (85% vs 67%; P less than 0.02). After six treatment weeks, healing tendency after omeprazole compared with ranitidine was 85% vs 45% (P less than 0.04). Omeprazole also brought earlier improvement in symptoms. The difference was statistically significant for heartburn (pyrosis): P less than 0.01. Both drugs were equally well tolerated and there were no clinically significant side-effects. This is the first demonstration that the ATPase inhibitor omeprazole is superior to the H2-receptor antagonist ranitidine in the treatment of reflux oesophagitis.

Administration, Oral↗
PubMed1986

20 versus 30 mg omeprazole once daily: effect on healing rates in 115 duodenal ulcer patients.

In a double-blind, dose comparison multicenter trial 115 patients with duodenal ulcer were treated with either 20 or 30 mg oral omeprazole once daily for 4 weeks. There was no difference in the healing rates for the two groups after 2 and 4 weeks. After 2 weeks with 20 and 30 mg healing frequencies were 79.0 and 72.7%, after 4 weeks 96.5 and 92.7%. No difference was observed between the groups in the number of pain episodes during day and night. No side effects to the drug occurred. A daily dose of 20 mg omeprazole may be effective in ulcer therapy.

Adult↗
PubMed1986

[The action of various doses of the new imidazole H2-receptor antagonist etintidine on intragastric acidity in man].

The chemical structure of etintidine differs from that of cimetidine by the addition of an ethinyl group to the terminal methyl group of the side chain. We investigated the influence of etintidine 300 or 400 mg b.d. and of etintidine 300 or 600 mg nocte, cimetidine 800 mg nocte versus placebo in two different double-blind randomized cross-over studies on 24-h intragastric acidity and nocturnal volume and acid secretion (12:00 midnight to 6:00 a.m.) in 12 and 8 healthy male volunteers, respectively. 5-10 ml of gastric contents were aspirated hourly via a nasogastric tube. The pH of the samples was determined using a glass electrode. The results were expressed in terms of H+-activity (mmol/l). Etintidine 300 or 400 mg b.d. reduced day- and nighttime acidity by 53 and 60% or 41 and 41%, respectively. Nocturnal acid secretion (mmol/l) was inhibited by 38 and 42%, resp. Etintidine 300 or 600 mg nocte and cimetidine 800 mg nocte (9:00 p.m.) lowered nocturnal intragastric acidity by 69, 84 and 79%, resp. Daytime inhibition was not observed. Our results suggest, that 1. etintidine 300 and 400 mg b.d. are equipotent in promoting peptic ulcer healing and 2. that this new imidazole H2-receptor antagonist is also effective in a single bedtime dose.

Adult↗
PubMed1986

[Rioprostil 600 micrograms at night: marked inhibition of nocturnal intragastric acidity in man].

Antisecretory doses of prostaglandin analogues of the E1 and E2 series have been shown to promote peptic ulcer healing. In this double blind randomized cross-over study we investigated the effect of oral Rioprostil 300 micrograms b.i.d., 600 micrograms hs and placebo on 24 h intragastric H+ activity in 9 healthy male volunteers (age 20-37 years). 5-10 ml of gastric contents were aspirated hourly via a nasogastric tube. The pH of the samples was determined using a glass electrode . The results were expressed in terms of H+ activity (mmol/l). Night acidity (AUC/h, 2400-0800) is decreased by rioprostil in a dose related fashion (300 micrograms: 52%, 600 micrograms: 74%). The effect on day-time (0900-1800) H+ activity is much less. Rioprostil 300 micrograms given at breakfast reduce day-time acidity by 33%. Our results suggest that 600 micrograms Rioprostil in a single bedtime dose is effective in peptic ulcer treatment.

Adult↗
PubMed1985

[Healing rates following omeprazole and ranitidine treatment of gastric ulcer. Results of a German multicenter study].

The effectiveness of omeprazole (20 mg orally each morning) or ranitidine (150 mg orally twice daily) in the treatment of gastric ulcer was compared in 184 out-patient in a randomized, endoscopically controlled multi-centre double-blind ("double dummy") trial. Healing rates with omeprazole after two, four and eight weeks were 43, 81 and 95%, respectively, those with ranitidine were 45, 80 and 90%, a statistically not significant difference. Independently of medication, small ulcers (less than 8 mm diameter) healed more quickly than larger ones. Ulcers in the body of the stomach responded poorest to both drugs. Smoking had no statistically significant effect on healing rate. Omeprazole and ranitidine had similarly favourable effects on symptoms. Neither side effects nor changes in biochemical parameters could be ascribed to omeprazole. Both drugs had equivalent effects on the healing of gastric ulcers in the stated dosages.

Adult↗
PubMed1985

[Short-term therapy of duodenal ulcer with omeprazole and ranitidine. Results of a German multicenter study].

In a randomized, endoscopically controlled double-blind trial the effectiveness of a single oral, morning dose of 40 mg omeprazole was compared with a twice daily oral dose of 150 mg ranitidine given to 334 ambulatory patients with duodenal ulcers. Under omeprazole 105 of 146 duodenal ulcers were demonstrated to have healed within 14 days (72%), compared with 95 of 160 (59%) on ranitidine. The difference is statistically significant (P = 0.0121). After 14 days smaller ulcers healed more quickly than large ones, regardless of the drug used: 80 of 110 with diameter 3-5 mm (73%); 48 of 90 with diameter more than 8 mm (53%). Smoking delayed healing [healing rate among non-smokers, 87 of 117 (74%); among smokers, 113 of 189 (60%)]. Healing rates among smokers receiving omeprazole and non-smokers receiving ranitidine were nearly identical. After 4 weeks, at 96 and 92% respectively, there was no difference in regard to healing rate. Both drugs had a similar influence on the symptoms. Thus, for the first time it has been demonstrated that omeprazole is superior to ranitidine after 14-day treatment of duodenal ulcer.

Adolescent↗
PubMed1985

Omeprazole heals duodenal, but not gastric ulcers more rapidly than ranitidine. Results of two German multicentre trials.

In two double-blind, randomized German multicentre trials the effects of omeprazole 20 mg mane and ranitidine 150 mg b.i.d. were compared for the first time in 334 outpatients with duodenal ulcer and 184 outpatients with gastric ulcer. In patients with duodenal ulcer endoscopically controlled healing rates after two weeks were 72% with omeprazole and 59% with ranitidine (p = 0.012); after 4 weeks 96 and 92%, resp. were healed (n.s.). In patients with gastric ulcer the healing rates after two, four, and eight weeks were 43, 81, and 95%, respectively, with omeprazole and 45, 80, and 90%, respectively, with ranitidine (n.s.). Smoking impaired healing in duodenal, but not in gastric ulcer. Symptom relief was comparable with both drugs. Serious side effects or clinically relevant changes in laboratory screening results were not detected. - Our results demonstrate for the first time that omeprazole 20 mg mane is superior to ranitidine 150 mg b.i.d. in the short-term treatment of duodenal, but not gastric ulcer.

Adolescent↗