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Biomedical subjects

R Hilgers

Publications and source records attributed to R Hilgers.

35 records · Page 2Linked to original sources
PubMed1988

Detection of pancreatic steatorrhea by oral pancreatic function tests.

Pancreolauryl and NBT-PABA tests were performed in urine of 54 patients with exocrine pancreatic insufficiency and, additionally, in serum of 29 of these patients. All patients underwent a secretin-pancreozymin test and a 72-hr fecal fat analysis. Pancreatic steatorrhea occurred (with only three exceptions) when the pancreolauryl test revealed a T/C ratio [recovery of the fluorescein of the test (T) and the control (C) day] of less than 10, or when serum fluorescein concentrations were below 0.5 microgram/ml. The NBT-PABA test also showed a negative correlation between urinary PABA excretion or serum PABA concentration and fecal fat excretion, but there was no diagnostically useful cutoff limit indicating decompensation of exocrine pancreatic insufficiency. These findings indicate that the pancreolauryl test may facilitate clinical evaluation of patients with chronic pancreatitis by simultaneously assessing exocrine pancreatic insufficiency as a cause and predicting pancreatic steatorrhea as a sequel of maldigestion. In clinical practice, the pancreolauryl test can be used as a parameter for deciding whether to initiate pancreatic enzyme substitution if direct pancreatic function tests and fecal fat analysis are not available.

4-Aminobenzoic Acid↗
PubMed1988

Thyroid autonomy: sensitive detection in vivo and estimation of its functional relevance using quantified high-resolution scintigraphy.

This study is concerned with 236 euthyroid individuals living in an area of iodine deficiency, 227 of whom had endemic goitres. In these subjects, autonomy could be suspected owing to an inhomogeneous activity distribution on the thyroid scintigram or a subnormal TSH response to TRH. They complete a total number of 426 investigated individuals. Previously, in 190 separated controls without evidence of autonomy, the reference ranges for the thyroid 99mTc pertechnetate uptake under suppression (TcUs), a measure for the non-suppressible thyroid iodide clearance, and for suppressibility of circumscribed thyroid regions, had been determined. These two parameters obtained by high-resolution quantified scintigraphy were used for an accurate detection of thyroid autonomy among the 236 individuals. Suppression scintigraphy revealed autonomy in 171 patients. delta TSH after TRH was subnormal in 40% of the subjects with abnormal thyroid suppressibility. Prevalence of abnormal suppression was dependent on three factors: patient age, goitre type and estimated thyroid weight. In the total investigated collective, the prevalence of autonomy was 77% in patients with a goitre weight above 50 g. The individuals with abnormal suppression were grouped into four classes of TcUs. In these classes, free thyroxine index (FT4I) and total triiodothyronine (TT3) increased with increasing TcUs, whereas delta TSH decreased. This finding indicates a continuum of different extents of autonomous thyroid function, whereas in the individual patient, the extent can be determined using the pertechnetate uptake under suppression. In addition, FT4I, TT3 and delta TSH in each of the TcUs classes depended on the individual iodine supply.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

[Facilitating cervix dilatation of the non-pregnant uterus by intracervical administration of gels containing prostaglandin and calcium chloride].

In a prospective, randomised study, 50 non-pregnant patients were treated intracervically with 3 ml 5% tylose, 50 micrograms sulprostone, 100 micrograms sulprostone gel, 3 ml 2.5 mM or 9.0 mM calcium chloride gel in order to soften the cervix 12-14 hours before diagnostic curettage. The gel was not used in a further 20 patients. To objectively demonstrate the priming effect, the force required for dilatation of the cervical canal was measured in Newtons, using a mechanical tonometer both before gel application and before the operation. In comparison with the administration of tylose only, the intracervical application of either sulprostone gel or calcium chloride gel led to a significant improvement in cervical dilatability. Tylose alone had a slight but measurable effect on the cervix. An increase in sulprostone from 50 micrograms to 100 micrograms or calcium molarity from 2.5 mM to 9.0 mM brought no further improvement in the dilatory effect. Dilatation-induced cervical lesions could be avoided by preoperative cervical ripening. After application of sulprostone, 3 out of 20 patients experienced doses-dependent uterine cramps, while all patients treated with calcium chloride gel were free of side effects. The intracervical administration of sulprostone and calcium chloride gel allowed gentle dilatation of the non-pregnant cervix, thus lowering the risk of uterine lesions. Under clinical aspects, cervical priming facilitates diagnostic and therapeutic procedures, which, in exceptional cases, can be performed without anaesthesia.

Administration, Intravaginal↗
PubMed1987

Physiological aspects of the thyroid trapping function and its suppression in iodine deficiency using 99mTc pertechnetate.

In an area of iodine deficiency, we investigated 190 individuals with and without euthyroid endemic goitre, who had a normal TSH response after TRH and an entirely homogeneous thyroid scintigram before and under suppression. In these subjects, the thyroid uptake of 99mTc pertechnetate, as a measure of the iodide trapping function, was determined before (TcUb) and under suppression (TcUs), using quantitatively evaluated scintigraphy. In this control group of individuals, without evidence of autonomy, the reference ranges of TcUb and TcUs were determined. The upper limit of the reference range for TcUb was 7.4% of the tracer activity injected, and for TcUs 1.6%. The reference range of TcUs is to be used to detect accurately thyroid autonomy in vivo. In addition, factors affecting the thyroid trapping function were investigated. With decreased iodine supply, trapping before suppression was increased, compensating for iodine deficiency. The effect of TSH on the trapping function was secondary, indicating that, to a considerable degree, the follicular cells adapt their iodide trapping to the iodine supply. The trapping before and under suppression increased with the estimated thyroid weight. delta TSH after TRH stimulation measured before suppression correlated inversely with the trapping under suppression. The two latter observations suggest that there is a continuum between low and increased levels of the TSH-independent thyroid function, even among these selected individuals without primary evidence of autonomous tissue. A correlation of the trapping function with sex, oestrogen treatment, and goitre type was not demonstrable. Age was found to have a small influence. Except for iodine contamination, the factors affecting the pertechnetate uptake of the thyroid, can be neglected under routine conditions.

Adolescent↗
PubMed1985

Facilitation of cervical dilatation by intracervical application of sulprostone gel prior to hysteroscopy.

In a prospective, randomized study, 10 patients with primary sterility received an intracervical application of 0.1 mg Sulprostone-Tylose gel for cervical priming 12 hours prior to panoramic CO2-hysteroscopy and pelviscopy with chromopertubation. Ten patients who served as controls were not treated with the local prostaglandin. The force required to overcome the cervical canal was measured with a special tonometer for Hegar 3 before application of the gel in the group treated with Sulprostone and was 3-8 mm in both groups of patients immediately preoperatively. Cervical priming led to a significant reduction in the force required to dilate the cervix. After priming with Sulprostone, the cervical canal was freely passable for an average of 6.7 mm. In none of these patients was a force of 7 Newton exceeded for Hegar 8, whereas in the control group a mean force of 8.2 Newton was required to dilate the cervix for Hegar 6. Haemorrhage and epithelial lesions of the cervix caused by the dilatation can largely be avoided, and the risk of uterine damage reduced by local priming of the cervix. The intracervical application of prostaglandin gel is an easy, efficient and gentle method of dilatation for hysteroscopy, particularly in patients with a firmly closed and rigid cervix.

Adult↗
PubMed1985

[Cervix priming in induced abortion in the 1st trimester using intracervical administration of sulprostone gel].

In a prospective, randomised study 40 primigravidae were treated intracervically with 0.05 mg or 0.1 mg Sulprostone-Tylose gel in order to soften the cervix prior to first trimester termination of pregnancy. Curettage was performed on the average 7.5 hours after prostaglandin administration. For objective demonstration of the priming effect, the force required for dilatation of the cervical canal was measured in Newtons by a special tonometer before prostaglandin application and before operation. The maximal dilatability with a force of 10 N, the increase in dilatability after local PG application, and the patency of the cervix were measured. The occurrence of PG-induced lower abdominal pain associated with contractions was analysed with regard to the number of episodes at pain, their timing and the required amount of analgesics. A modified visual analogue scale was used to evaluate the subjective pain experience. The abortive effect of 0.1 mg Sulprostone was found to be more efficient than the 0.05 mg dose. There was no statistical significant difference between the two doses, however, for the priming effect detectable with the tonometer. The subjective experience of pain, use of analgesics and the frequency of gastrointestinal side effects were significantly higher with 0.1 mg than with 0.05 mg Sulprostone. The visual analogue scale allows the patient to quantify, at least to some extent, her experience of pain, and enables a differentiated analgetic therapy. Because of its effectiveness and low rate of side effects, the intracervical application of 0.05 mg Sulprostone gel promises to be an advantageous alternative to other methods of cervical priming.

Abortifacient Agents↗
PubMed1985

Effect of dialysate glucose load on plasma glucose and glucoregulatory hormones in CAPD patients.

The effect of a dialysate exchange with both 1.5 and 4.25% glucose solutions on plasma levels of glucose, insulin, gastric inhibitory polypeptide (GIP), and glucagon has been investigated in 5 continuous ambulatory peritoneal dialysis (CAPD) patients. Only in the case of the 4.25% solution did plasma glucose levels rise above 100 mg/dl. 4 of the 5 patients responded to this change with a marked insulin secretion. Employing the 1.5% solution, plasma glucose remained stable and only a slight insulin stimulation was observed in 2 patients. It is concluded that provided the 4.25% dialysates are used only occasionally, there will be no continuous stimulation of the pancreatic beta-cells due to absorption of glucose from the dialysate alone during CAPD treatment. GIP levels are highly elevated in CAPD patients. A dialysate exchange with either a 1.5 or a 4.25% glucose solution had no effect on this gastrointestinal hormone. Hyperglucagonemia was also observed in this collective. An initial suppression of glucagon levels occurred in 4 of the patients after a 4.25% dialysate exchange. The 5th patient demonstrated an initial rise followed by a later decrease in glucagon, a response similar to that reported in adult onset diabetes after an oral glucose tolerance test.

Adult↗
PubMed1984

Humoral immune response in Epstein-Barr virus infections. II. IgG subclass distribution in African patients with Burkitt's lymphoma and nasopharyngeal carcinoma.

Native Burkitt's lymphoma (BL) and nasopharyngeal carcinoma (NPC) patients from Kenya were examined with regard to the serum concentrations and distribution of the four IgG subclasses, total IgG, and antibody activities to Epstein-Barr (EB) virus associated antigens. The results were compared with corresponding data of an African control group. As revealed by indirect immunofluorescence techniques, the patients displayed a pattern of IgG and IgA antibodies to EB virus associated antigens which is characteristic for these diseases. No significant differences could be detected between the total IgG levels of the diagnostic groups. The mean total IgG concentrations of our Kenyan patients were two to three times as high as those found in four different groups of Europeans, which is consistent with results of previous studies on Gambian, Nigerian, and Congolese Bantu populations. Quantitative determination of the four IgG subclasses by radial immunodiffusion revealed a unique pattern in the BL group which was characterized by a decreased proportion of IgG2 and significantly lower absolute IgG2 values as compared with the controls. The IgG subclass distribution pattern in the African NPC sera was essentially identical with that of European NPC and African control sera. The pathogenetic implications of these findings are discussed.

Adolescent↗
PubMed1983

Comparative study of various intracervically administered PG gel preparations for termination of first trimester pregnancies.

In a randomized, double-blind study, 30 healthy, nulliparous women of similar gestational age were given intracervical applications of 0.5mg PGE2, 0.05mg Sulprostone or 0.1mg Sulprostone gel in order to soften the cervix prior to curettage for first trimester termination of pregnancy. The preparations were administered 8 hours before curettage. The number of complete and incomplete abortions, ease of passage through the cervical canal, as measured by a tonometer before and 8 hours after the administration of prostaglandin, the degree of pain experienced and the quantity of analgesics required, plus the frequency of systemic side effects were all always assessed by one trialist. With regard to the rate of abortion and cervical softening, the administration of 0.1mg Sulprostone gel proved the most effective method. However, in comparison with the others, it also caused the greatest degree of pain and necessitated the greatest use of analgesics. The softening effect of the prostaglandin E2 gel was significantly less and in this group there were two cases of cervical lesion due to tenaculum laceration. The intracervical application of 0.05mg Sulprostone gel is to be recommended for pre-operative ripening of the cervix before termination of pregnancy in the first trimester, as it effectively dilates the cervix and does not cause systemic side effects or pain in the lower abdomen, enough to make treatment necessary.

Abdomen↗
PubMed1983

[Plasma hormone concentrations in induced abortion with local prostaglandin administration in the 1st trimester].

Abortion was performed by curettage on 71 women with pregnancies between the 7th and the 13th week of gestation seven to eight hours after intracervical application of a tylose gel containing 3mg prostaglandin F2 alpha. Prior to the application of the prostaglandin and immediately before the surgical intervention a sonographic examination for determining the vitality of the pregnancy was carried out.--Plasma progesteron, estradiol and HPL levels were determined radioimmunologically prior to the application of prostaglandin, at four-hour intervals on the day of intervention, and 24, 48 and 72 hours after the intervention. In 22 women a complete or an incomplete abortion occurred; in two cases a blighted ovum was observed; 47 pregnancies, according to sonographic examination, remained intact until curettage. After seven to eight hours duration of the effect of the prostaglandin gel, progesterone levels were found to be reduced to 60.5 per cent and 17-beta-estradiol to 31.4 per cent of the initial values, whereas the HPL values fell below the specificity of the testing procedure (12.5 ng/ml). Comparative investigations of the pregnancies which, according to sonographic findings, remained intact until curettage and those which were aborted after the application of prostaglandin did not, in spite of low plasma progesterone and estradiol levels in the abortive group, reveal any statistically significant differences. The abortive effect--even with local application--of the prostaglandins was confirmed. Conclusions regarding the effective mechanism of the prostaglandins upon the fetoplacental unit and the function of the corpus luteum remain subject to speculation.

Abortion, Induced↗
PubMed1982

Humoral immune response in Epstein-Barr virus infections. I. Elevated serum concentration of the IgG1 subclass in infectious mononucleosis and nasopharyngeal carcinoma.

Using radial immunodiffusion we measured IgG subclass concentrations and studied their distribution in serum samples from patients with infectious mononucleosis (IM) and nasopharyngeal carcinoma (NPC), two Epstein-Barr virus (EBV)-associated diseases, in comparison with two control groups [completely anti-EBV negative persons and subjects carrying antibodies to the viral capsid antigen (VCA)]. Antibody titres to VCA and to the early antigen (EA) were determined by indirect immunofluorescence and revealed characteristic patterns for the respective diagnostic groups. Nephelometric assays served for quantitating total protein, albumin, total IgG, IgA and IgM in all the sera. In the IM and NPC groups the concentration of IgG1 was significantly elevated by more than 50% whereas the other three subclasses remained unchanged as compared with the controls. Correspondingly, we found a significant increase of total IgG in IM and NPC. In IM, the only disease where VCA-specific IgM antibodies have been reported to occur, IgM levels were markedly elevated. Our data suggest that the IgG1 subclass plays an important role in the humoral immune response to EBV-determined antigens and that it is possibly involved in the control of virus infection.

Animals↗
PubMed1980

Blood lymphocyte subpopulations show characteristic changes during ACTH therapy in acute exacerbations of multiple sclerosis.

The percentages of the various lymphocyte subpopulations in blood samples of 22 patients suffering from acute bouts of multiple sclerosis (MS) were determined by E rosette formation and peroxidase staining techniques, respectively, before and during ACTH therapy. In accordance with earlier reports, most of the subjects showed a normal increase of their plasma cortisol concentrations in an ACTH quick test, which was routinely performed before the beginning of therapy. We observed a significant transitory decrease of the absolute and relative T-cell proportions with a minimum around the tenth day of treatment, accompanied by inverse changes of the null-cell numbers. The concentrations of total white blood cells, total lymphocytes, B-cells, and monocytes did not change significantly. Our results are consistent with data reported in the literature on follow-up studies of lymphocyte subpopulations in patients with myasthenia gravis undergoing treatment with ACTH and corticosteroids, respectively. Recent experimental findings indicate that T-helper cell activity can be regulated by a negative feedback control mechanism. In consideration of these reports, we discuss the significance of changes in the distribution of lymphocyte subpopulations for the therapeutic action of ACTH and corticosteroids in MS.

Acute Disease↗
PubMedDate not supplied

Method to detect minimal amounts of calcium dissolved in acidic solutions.

The study describes the application of the Arsenazo III method for detection of minimal amounts of calcium 12.4-49.4 micromol/l in different acidic solutions (hydrochloric acid, oxalic acid, maleic acid, phosphoric acid, tartaric acid, citric acid, lactic acid and acetic acid) adjusted to pH 2.0, 2.3 and 3.0. A mixture of the respective calcium concentrations with distilled water served as control. The experiments were run with ten repeats in series. Assessment of intra- and interassay coefficient of variation, and lower limit of quantification revealed that depending on the acid used, the Arsenazo III method is a reliable tool to quantify minimal calcium contents in acidic solutions.

Arsenazo III↗
PubMedDate not supplied

Mitomycin C and bleomycin in the treatment of far-advanced cervical cancer: a Southwest Oncology Group pilot study.

Under the auspices of the Southwest Oncology Group, Wayne State University tested a schedule using bleomycin and mitomycin C that was previously reported to give a response rate of 88%. In our patients the same regimen produced similar toxic effects but a far different response rate of 15.8% (one complete remission and two partial remissions). The only discernible difference in the two patient groups was the amount of radiation given prior to chemotherapy.

Bleomycin↗
PubMedDate not supplied

[Relation between procoagulant activity and fetal lung maturity in amniotic fluid].

A total of 146 samples of amniotic fluid from the 15th to 43rd weeks of pregnancy were taken by either transabdominal amniocentesis or amniotomy during birth. In addition to the palmitic/stearic ratio (P/S) the following coagulation tests were determined: clotting time, modified prothrombin time, partial thromboplastin time (PTT), recalcification time and, in selected samples, thrombelastograms. In the course of pregnancy there is a significant shortening of all coagulation tests measured in amniotic fluid. Comparing the values obtained in the 15th to 18th and the 37th to 43rd weeks of gestation and literature results the following values may indicate fetal maturity: clotting time less than 100 sec., modified prothrombin time less than 80 sec., PTT less than 30 sec. and recalcification time less than 80 sec. The lower limit for P/S ratio in normal pregnancy is 5,0. In 58 cases, amniotic fluid was obtained in the 37th to 43rd week at most 24 hours before delivery; there was no case of RDS in this group. Eliminating intermediate P/S values of 4,5 to 5,0 a false negative rate of 1,7% for the prediction of fetal lung maturity was seen. The corresponding rate for the modified prothrombin time was 3,4% and for the clotting time 6,4%. In 7 RDS cases all cases could be properly predicted from the recalcification time and the PTT. The fetal lung maturity may be estimated by means of simple and rapid coagulation tests and this may facilitate the indication for RDS-prophylaxis. The determination of the L/S or P/S ratios, however, cannot yet be dispensed with.

Amniotic Fluid↗