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S Rittig

Publications and source records attributed to S Rittig.

15 recordsLinked to original sources
PubMed1992

Monosymptomatic bedwetting.

An update of the pathogenesis and treatment of monosymptomatic bedwetting is presented. This frequently occurring entity seems to have a multifactorial pathogenesis incorporating arousal disturbances and disturbances to the circadian rhythm of diuresis modulating hormones. It has recently been substantiated that the bladder reservoir function in monosymptomatic bedwetting is normal. This is further underlined by the fact that treatment of instability of the bladder has proven futile. In a substantial part of the monosymptomatic bedwetters the changes in circadian rhythm of antidiuretic hormone can be counteracted by desmopressin diacetate (DDAVP), which abolishes the symptom in more than 2/3 of the patients. Monitoring circadian rhythms of arginine vasopressin (AVP) and treatment with DDAVP have led to increased understanding of the pathogenesis of monosymptomatic bedwetting and opened new fields of investigation.

Arginine Vasopressin↗
PubMed1991

The hemodynamic effects of triglycyl-lysine-vasopressin (Glypressin) in patients with parkinsonism and orthostatic hypotension.

The hemodynamic effects of triglycyl-lysine-vasopressin (TGLVP) were investigated in a single-blind study in seven patients with chronic orthostatic hypotension and parkinsonism. Blood pressure, heart rate, and stroke volume were measured in the supine position before and after bolus injection of either placebo or TGLVP (5.0, 7.5, or 10.0 micrograms/kg of body weight). After 40 min in the supine position, the patients were head-up tilted to 45 degrees for 20 min. All patients underwent four tilt studies with different medication. The TGLVP increased supine blood pressure by approximately 25% and total peripheral resistance by approximately 46%, and reduced heart rate by approximately 13%. No changes in supine stroke volume or cardiac output were seen. The TGLVP slightly reduced the relative fall in blood pressure and increased heart rate during the tilt. After TGLVP, blood pressure levels during tilt were similar to supine levels prior to medication. The TGLVP did not change the effects of tilt on stroke volume or cardiac output. Only few and mild side effects were experienced and no cardiotoxic effects were observed. In conclusion, TGLVP showed marked blood pressure effects of very small doses in this category of patients. The clinical effects of TGLVP and other vasopressor-specific analogs of vasopressin should be tested in these patients.

Aged↗
PubMed1991

Long-term treatment of nocturnal enuresis with desmopressin. A follow-up study.

Eight patients with monosymptomatic nocturnal enuresis (age 11-24 years) were investigated prior to and after 24 weeks of desmopressin treatment in order to evaluate the impact on the endogenous vasopressin secretion and urinary output. No effect on plasma vasopressin, diurnal urinary volume, and urinary osmolality were found after this long-term treatment. Overall no changes in either body weight, blood pressure, or hematological variables were demonstrated. This supports previous findings that the treatment appears to be well tolerated and free of side effects in longer term.

Adolescent↗
PubMed1991

Diurnal variation of plasma atrial natriuretic peptide in normals and patients with enuresis nocturna.

The circadian variation of plasma atrial natriuretic peptide (ANP) in relation to urinary excretion of sodium (UNa) and potassium (UK) as well as clearance of creatinine (Ccrea) was assessed in 15 juvenile patients with enuresis nocturna and compared with 11 age-, sex-, and weight-matched normal subjects. Normal juveniles showed a highly significant diurnal variation (p less than 0.001) of plasma ANP with diurnal peak levels at midnight (0000 hours) and minimum levels at 0400 hours. Enuretic patients showed a similar diurnal rhythmicity with normal levels during day and night. In normals both UNa and UK showed significant diurnal rhythmicity with a marked reduction from daytime to night-time. Although the total diurnal excretions of UNa and UK were similar to normals, patients with enuresis showed abnormal diurnal variation in both UNa (p less than 0.05) and UK (p less than 0.01). The abnormal circadian rhythm of UNa and UK in enuretics seemed to be caused by abnormal tubular handling as similar abnormalities were found in the fractional excretions and as the circadian variation of Ccrea was normal. Especially during the first hours of sleep (2200 hours to 0000 hours), the patients showed polyuria (230 +/- 138 ml vs 116 +/- 58 ml, p less than 0.01), natriuresis (20.9 +/- 16.3 mmol l-1 vs 10.7 +/- 6.8 mmol l-1, p less than 0.01), and kaliuresis (7.3 +/- 6.3 mmol l-1 vs 3.7 +/- 2.3 mmol l-1, p less than 0.05), despite normal levels of plasma ANP. In conclusion, the study describes the diurnal variation of plasma ANP in relation to urinary excretion of sodium and potassium in a juvenile normal population. Patients with nocturnal enuresis show abnormal diurnal rhythmicity in the urinary excretion of sodium and potassium that is not correlated to the plasma levels of ANP.

Adolescent↗
PubMed1991

Measurement of anal cross-sectional area and pressure during anal distension in healthy volunteers.

A probe for simultaneous measurement of cross-sectional area and pressure was used to elucidate biomechanical wall properties during anal distension. Measurements in distal sphincter regions demonstrated a high resistance to stretch and a large hysteresis compared to proximal sphincter regions. Resistance to stretch decreased during anal distension indicating an active relaxation mechanism at all recording levels. The zone with high resistance to stretch was located more distal than the high-pressure zone measured by anal-pressure profilometry. In conclusion, biomechanical wall properties of the anal canal cannot be described by classic viscoelastic theories but rather by a loss of sphincter tone caused by reflex mechanism during anal distension.

Adult↗
PubMed1989

Sleep cystometries in children with nocturnal enuresis.

A combined analysis was done of sleep and bladder filling during sleep. Cystometry did not specifically affect sleep, since most of the cystometry studies in cases of enuresis did not lead to sleep stage changes on electroencephalography. Bladder instability was not accompanied by lighter sleep. Increasing patient age did not appear to have any influence on sleep or bladder behavior. We conclude that it is possible to provoke enuresis at any sleep stage and that sleep is unaffected by bladder filling in enuretic patients.

Adolescent↗
PubMed1989

The effect of a new selective alpha 2-adrenoreceptor antagonist, idazoxan, and the agonist, clonidine, on fasting antroduodenal motility in healthy volunteers.

Studies were carried out on 16 healthy male volunteers to investigate whether intravenous administration of the alpha 2-adrenoreceptor antagonist, idazoxan, could affect fasting antroduodenal motility with and without administration of the agonist, clonidine. Contractile activity was recorded using an oral tube with perfused side holes positioned in the stomach and duodenum. Clonidine decreased antral contractile activity, an effect that idazoxan did not restore. Idazoxan alone did not affect antral motility. In the duodenum, clonidine decreased the number of contractions significantly and idazoxan restored them. Idazoxan alone did not increase duodenal motility but clonidine induced phase-III activity within the first 15 min after administration. The observations indicate that regulation of antroduodenal motility is influenced by alpha 2-adrenoreceptor drugs. Idazoxan may have potential as a motility restoring drug, for example, in postoperative ileus.

Adolescent↗
PubMed1989

Abnormal diurnal rhythm of plasma vasopressin and urinary output in patients with enuresis.

The diurnal variation of plasma vasopressin (AVP), urinary excretion rate, urinary osmolality, and serum osmolality was studied twice in 15 patients with enuresis and in 11 age, weight, and sex matched nonenuretic normal subjects. A diurnal rhythm of AVP with constant levels during the day (8 AM-10 PM) and a highly significant increase during the night (10 PM-8 AM) was found in normal subjects. In contrast, enuretics showed a significantly less pronounced nocturnal increase in AVP with significantly lower nocturnal levels than normal subjects. Normal subjects showed a diurnal rhythm in urinary excretion rate reciprocal to urinary osmolality with a low and highly concentrated nocturnal urinary output. In enuretics, however, this normal diurnal rhythm was absent. In conclusion, an abnormal diurnal rhythm of AVP seems to be an important pathophysiological factor in enuresis, explaining the abnormally high nocturnal urinary volume and the low nocturnal urinary osmolality found in these patients.

Adolescent↗
PubMed1989

Adult enuresis. The role of vasopressin and atrial natriuretic peptide.

In 8 adult patients with monosymptomatic nocturnal enuresis (age 18-44 years) we twice investigated the circadian rhythm of plasma vasopressin, plasma atrial natriuretic peptide, serum osmolality, serum electrolytes as well as urinary excretion in relation to urodynamic variables. Seven of the patients showed a lack of diurnal rhythmicity in plasma vasopressin at both diurnal studies with no night-time increase. The nocturnal urinary volumes exceeded the bladder capacities with an average of 155%. This was mainly caused by a large excretion of poorly concentrated urine during the first hours of sleep. Although a slight nocturnal peak in plasma atrial natriuretic peptide was found no clear pathophysiological role could be determined for this peptide. It is concluded that the previously established vasopressin production abnormality in juvenile enuresis seems to persist in adult enuretics.

Adolescent↗
PubMed1989

Computer analysis of manometric recordings. A study of overnight rectal activity in normal children.

To read and analyze manometric tracings from selected biological systems, a computer program was produced using low cost personal computer hardware. The program contains facilities for automatic scoring of contractions, intercontractile intervals (modality) and frequency analysis. This report concerns analysis of two overnight rectal motility recordings in 11 normal teenagers. After A/D conversion of data the developed software offers a set of options i.e. automatized scoring of contraction, detection of intervals between contractions and analytical tools such as histographic presentation of data, and presentation in the time domain. The A/D conversion time and computer analysis time for an 8 hour recording was 15 and 13 minutes, respectively. The analysis of frequency distribution overnight showed for the material as a whole 63% of no activity, 33% of 0-2 contractions x min-1 and 4% of more than 2 contractions x min-1. Modality analysis showed a peak between 15 and 25 seconds. Approximately 30% of the tracings showed accumulated intervals, which were multiples of the peak. No significant correlation was found between the first and second night of observation regarding the number of contractions and maximum frequency overnight. Significant correlation was found for the number of periods with high frequency activity between the two nights (p less than 0.05). Long-term pressure activity can be analyzed using the presented computer-aided method, providing a rapid and objective measurement of classical parameters and access to more in-depth analysis. This actual study of normal overnight rectal activity showed a large inter- and intra-individual variation.

Adolescent↗
PubMed1989

Nocturnal studies in enuretics. A polygraphic study of sleep-EEG and bladder activity.

In patients with monosymptomatic enuresis we investigated bladder activity together with electroencephalography during sleep on two consecutive nights. Thirty-one patients were investigated. Enuretic episodes were found to be normal micturitions not related to any specific sleep stage. Except for a very few bladder contractions outside the enuresis episode we did not observe any bladder activity. In the few instances where bladder activity was seen it was not associated with changes in EEG activity. The bladder contractions were all eliminated by pelvic floor activity, and this could be seen without any disturbances of the sleep indicating that voiding can be inhibited without the child waking up.

Adolescent↗
PubMed1988

The relation between antral contractile activity and the duodenal component of the migrating motility complex.

The aim of the study was to investigate the relationship between antral and duodenal fasting motor activity in 19 healthy volunteers using a perfused tube assembly with side-holes placed in the distal antrum, second part of the duodenum and in the duodenum near the ligament of Treitz. Registrations were performed until the end of the second duodenal phase III. Eighty-two per cent of the duodenal phases III were preceded by antral activity. The duration of duodenal phase III showed a positive correlation to the preceding number of antral contractions (p less than 0.001) as well as to antral phase III (p less than 0.05), but no correlation to the duration of antral phase III was found. The duration of the migrating motility complex (MMC) showed a positive correlation to the duration of duodenal phase III (p less than 0.05), but no correlation to the preceding number of antral contractions were found. It may be concluded that the level of duodenal activity is very dependent on the preceding antral activity.

Adult↗
PubMed1988

The effects of glucagon and glucagon-(1-21)-peptide on antroduodenal motility in healthy volunteers.

Since it has been argued that the spasmolytic effect of glucagon is related to the first 21 N-terminal amino acid residues, and not to the complete molecule, we have compared the effects of glucagon-(1-21)-peptide (G-(1-21) and glucagon on human antroduodenal motility. Glucagon and G-(1-21) were given as bolus injections to 30 healthy volunteers equally allocated into five groups. Each subject received two doses; one was placebo, 0.25, 0.5, 1.0 or 2.0 mg of glucagon, the other was an equimolar doses of G-(1-21) (placebo, 0.175, 0.35, 0.70 or 1.4 mg of G-1-21). The first injection was given during phase II of a migrating motility complex (MMC), and the next during the following phase II. Contractile activity was recorded using an oral tube with one sidehole positioned in the antrum and two in the duodenum. We confirmed that glucagon decreases the number of contractions in the antrum and duodenum and that normal phase II activity was restored within 20-40 minutes proportionally to the amount of the drug given. G-(1-21) did not change antroduodenal motility nor did it affect the phase II pattern in any of the groups. Neither were any side effects encountered. G-(1-21) does not seem to be an alternative to glucagon and other spasmolytic drugs for obtaining relaxation of the antroduodenal area.

Adult↗
PubMed1987

Urethral pressure variations in healthy females during rest and sleep.

Recent studies have shown the occurrence of rhythmic urethral pressure variations (UPV) in the normal female urethra in the awake state. The nature of these variations still needs further elucidation. In this study we investigated the changes in urethral pressure (UP) and in UPV as they occur in healthy females awake and asleep. UPV, intravesical-(IVP) and rectal pressure (RP), together with anal electromyography (EMG) and electroencephalography (EEG) were measured in 10 healthy fertile female volunteers. The registration was done in the awake state, during falling asleep and during sleep. During falling asleep the average urethral pressure as well as the UPV amplitude and frequencies decreased and remained at a lower stable level during sleep. Urethral pressure and its variations seemed to be interrelated since the UPV frequency and amplitude decreased when the average UP decreased. From this study it appears that urethral pressure is influenced by extrinsic factors such as the waking, resting and sleeping states. Although some extrinsic modulation of urethral pressure variations occurs, their persistance in sleep suggests their local nature.

Adult↗