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Biomedical subjects

U Grötzinger

Publications and source records attributed to U Grötzinger.

At least 19 recordsLinked to original sources
PubMed1992

[Ambulatory hernia surgery].

Ambulatory surgery for hernia repair is not generally used in Switzerland. Tradition, patients' expectations and the insurance system still favour hospitalization. Nationwide, the mean length of stay amounted to 8.7 days in 1990. A five-year experience is presented, using transversalis fascia repair for uncomplicated unilateral hernia and encouraging immediate ambulation. In 530 patients, the mean duration of hospital stay was 4.4 days. In 446 of these cases, local anesthesia was used, and two thirds of the patients were discharged by the second postoperative day. Thus, it seems possible to gradually approach short-stay surgery for inguinal hernia repair even in Switzerland.

Ambulatory Surgical Procedures↗
PubMed1992

[Effect of continuous postoperative analgesia with peridural bupivacaine on intestinal motility following colorectal resection].

In a prospective randomized trial the effects of continuous peridural analgesia on gastrointestinal motility and the postoperative course was studied in 48 consecutive patients with elective colorectal resections. 24 patients had peridural analgesia (PDA) with bupivacaine while 24 patients received intravenous analgesia (IVA) with pentazocine. With PDA the first passage of flatus and faeces was significantly accelerated. PDA was not associated with an increased rate of anastomotic breakdown and there were no respiratory complications in the PDA group.

Aged↗
PubMed1991

[Early results of transversalis-plasty. A prospective randomized comparison of non-resorbable and resorbable sutures].

In a prospective randomized trial we analyzed the perioperative management, complications, and the recurrence rate of inguinal hernia repair using either resorbable (polydioxanone, PDS) or non-absorbable (polyamide, Ethilon) suture material. From January 1988 to June 1989, 484 consecutive transversalis fascia repairs were performed in 425 adult patients with inguinal or femoral hernia. Local anaesthesia was used in 273 cases. At least one year postoperatively, 390 patients with 445 repairs had a clinical follow-up. The recurrence rate after 360 primary herniae was 3.3% (Ethilon 2.3%, PDS 4.3%) while 5.9% rerecurrences were found following operation for recurrent hernia (Ethilon 2.5%, PDS 8.9%). The differences in the recurrence rates following the use of polyamide or polydioxanone were not statistically significant. Complications occurred in 5.2%. The postoperative hospital stay averaged 3.8 days and work was resumed after a mean of 3.9 weeks.

Adolescent↗
PubMed1988

[Progress in the treatment of inguinal hernia].

Modified Bassini's procedure until recently used to be the optional surgical approach to inguinal hernia at the authors' hospital. A ten-year retrospective study was conducted into 1,687 patients. Contact was actually established with 1,037 of them. Of these 762 returned a questionnaire sent to them, and 345 were available for clinical follow-up checks. These clinical examinations revealed a rate of recurrence of 7.2 per cent, following primary surgery. We have, therefore, changed our approach and have adopted a modified Shouldice procedure.

Female↗
PubMed1987

Gastrin is not a physiological regulator of pancreatic exocrine secretion in the dog.

The role of gastrin as a regulator of exocrine pancreatic secretion has not been proven adequately. In the present study we therefore compared the relative molar potencies of sulfated and unsulfated gastrin 17 with structurally related CCK peptides (synthetic CCK-8 and natural porcine CCK-33) in stimulating exocrine pancreatic secretion in conscious dogs. Dose response curves were constructed for pancreatic and gastric acid secretion. Plasma gastrin levels after exogenous gastrin 17-I and -II were compared with postprandial gastrin concentrations (meal: ground beef 20 g/kg body wt). The molar potency estimates calculated with synthetic CCK8 as standard (potency = 1.00) for pancreatic protein secretion were natural porcine 50% pure CCK-33 1.60, gastrin 17-I 0.12, and gastrin 17-II 0.16. All four peptides induced a dose-dependent increase in pancreatic bicarbonate output. However, the blood concentrations needed to stimulate pancreatic secretion were above the postprandial gastrin levels. Our data indicate that both gastrin 17 peptides are not physiological regulators of pancreatic enzyme secretion in dogs.

Animals↗
PubMed1986

Effect of circulating somatostatin on exocrine pancreatic secretion in conscious dogs.

We determined the effects of exogenous somatostatin-14 (100 and 200 ng/kg/h; mimicking postprandial somatostatin concentrations) on pancreatic responses to a background infusion of secretion in combination with graded doses of CCK-8 in conscious dogs with chronic gastric and duodenal fistulas. The lower dose of somatostatin-14 (S-14), which produced S-14 plasma levels lower than measured after a meal, did not change basal or stimulated pancreatic secretion. The upper dose of S-14, which produced plasma S-14 concentrations slightly above the postprandial range, caused inhibition of pancreatic fluid and protein secretion to low doses of CCK-8 (p less than 0.05). The inhibition was surmountable with higher doses of CCK-8. We interpret these data as indicating that circulating S-14 is not an important hormonal regulator of exocrine pancreatic secretion.

Animals↗
PubMed1986

Effect of exocrine pancreatic secretagogues on circulating somatostatin in dogs.

Several secretagogues of exocrine pancreatic secretion have been proposed to act as regulators of pancreatic D-cell function. To characterize this relationship, we measured incremental responses of protein, bicarbonate, and circulating somatostatin to graded doses of intravenous cholecystokinin (CCK-33), CCK-8, caerulein, bombesin, secretin, and intraduodenally perfused HCl, sodium oleate, and L-phenylalanine in conscious dogs with gastric and pancreatic fistulas and compared them with postprandial values (to a beef meal). Bombesin produced dose-related increases in somatostatin secretion (maximal, 46% of meal response), but caerulein, CCK-33, and CCK-8 released only small amounts of somatostatin at doses equivalent for pancreatic protein secretion. Secretin did not stimulate somatostatin release at any dose studied, whereas intraduodenal HCl at a load submaximal for pancreatic bicarbonate secretion increased somatostatin levels slightly (maximal, 16% of meal response). L-Phenylalanine and sodium oleate markedly increased protein secretion, but only oleate clearly stimulated somatostatin release (maximal, 11% of meal response). Our results suggest a greater quantitative importance of the intestinal phase for exocrine pancreatic stimulation than for somatostatin release.

Animals↗
PubMed1986

[Rectal prolapse].

Explore the source record for details and available documents.

Fecal Incontinence↗
PubMed1979

Vagovagal stimulation of pancreatic-polypeptide secretion by graded distention of the gastric fundus and antrum in man.

Previous studies have shown that pancreatic polypeptide (PP) secretion is regulated by efferent, vagal stimulation. In the present study the afferent part of a vagovagal pathway has been investigated in two different ways: (I) Graded fundic distention: in 8 patients with duodenal ulcer ballon distention with 150 ml of the fundus and the body of the stomach increased PP concentrations in plasma from 19 (17--26) to 41 (35--48) pmol/l, median and interquartile range. Distention by 300 and 600 ml did not further increase PP concentrations. After denervation of the fundus by proximal gastric vagotomy, no increase in PP levels was observed during distention with 50 and 300 ml whereas distention by 600 ml was followed by a small increase. (II) Graded antral distention: balloon distention with 50, 100 and 150 ml of the antrum increased plasma PP concentrations in 7 healthy subjects and 14 duodenal ulcer patients. Maximal PP response was achieved by distention with 100 ml, healthy subjects: from 14 (12--23) to 40 (26--44) pmol/l, and duodenal ulcer patients: from 25 (13--38) to 47 (22--63) pmol/l, median and interquartile range. It is concluded that a gastropancreatic reflex stimulating PP secretion through a long vagovagal pathway is present in man, and that this mechanism probably is involved in the initial PP response during a meal.

Adult↗
PubMed1978

Evidence for a defective inhibition of pentagastrin-stimulated gastric acid secretion by antral distension in the duodenal ulcer patient.

Graded antrum distension by 50-, 100-, and 150-ml balloon volumes significantly stimulated gastric acid secretion in 6 duodenal ulcer patients, but had no stimulatory effect in 6 healthy subjects. Antrum distension by 150-ml balloon volume had no effect on the acid response to submaximal stimulation by a continuous intravenous infusion of pentagastrin in the duodenal ulcer patients, but significantly inhibited this response in the healthy subjects. The inhibition by antrum distension in the healthy subjects amounted to 20%. The results suggest that antrum distension elicits stimulatory as well as inhibitory mechanisms in man with inhibition of acid secretion predominating in healthy subjects and stimulation of acid secretion predominating in duodenal ulcer patients. The mechanism of inhibition is unknown.

Adult↗
PubMed1977

Effect of fundic distension on gastric acid secretion in man.

The effect of distension of the fundus and body of the stomach on gastric acid secretion was studied in 26 patients with duodenal ulcer and six healthy subjects. Graded distension produced by inflating a rubber balloon to volumes of 150, 300, and 600 ml resulted in significant sequential increments of acid output. The secretory response outlasted stimulation by at least one hour. In both groups of subjects, the highest acid output obtainable with fundic distension amounted to just above 50% of the maximum secretory response evoked by intravenous infusion of pentagastrin. A significant correlation was found between the peak secretory rates observed during fundic distension and after pentagastrin stimulation. It is concluded that distension of the oxyntic gland area in man is a potent stimulus for gastric secretion of acid and that patients with duodenal ulcer are no more sensitive to this stimulus than healthy subjects.

Adult↗
PubMed1977

Effect of atropine and proximal gastric vagotomy on the acid response to fundic distension in man.

In four healthy subjects and in 12 patients with duodenal ulcer (DU), graded balloon distension of the gastric fundus and body caused increments in acid output related to the distension volumes. The mean peak distension response amounted to about 50% of the mean peak acid output (PAOpg) evoked by intravenous infusion of pentagastrin in a dose of 300 microng/h, eliciting maximum observed secretory response. During distension with the largest balloon volume, 1-0 mg atropine injected intravenously significantly depressed the acid secretory rate, the median inhibition amounting to about 80%. In two patients with DU, 2-5 mg atropine completely abolished acid secretion during fundic distension. In nine subjects with DU, complete proximal gastric vagotomy profoundly depressed the secretory responses to graded fundic distension, eliminating the acid response to the smallest balloon volume used. A slight, but significant, response to the largest distension volume persisted after complete vagotomy. Incomplete proxomal gastric vagotomy was found to reduce only moderately the distension responses in five patients, and the peak acid response to fundic distension as related to PAOpg remained unchanged. In conclusion, distension of the gastric fundus and body in man stimulates acid secretion by means of an atropine-sensitive, presumably cholinergic, reflex mechanism and the findings after vagotomy are in agreement with the concept that this reflex mechanism is conveyed by both short intramural and long vagovagal pathways.

Adult↗
PubMed1977

Effects of fundic distention on pentagastrin-stimulated gastric acid secretion in man.

The acid secretory effect of combined stimulation with balloon distention of the fundus and body of the stomach and intravenous infusion of pentagastrin has been studied in patients with duodenal ulcer (DU) and in healthy subjects. In 8 nonoperated DU subjects and in 5 DU patients subjected to proximal gastric vagotomy, low grade fundic distention moderately enhanced the acid output evoked by a threshold dose of pentagastrin. Fundic distention with a baloon volume eliciting a maximal acid response to distention either left unchanged or suppressed the maximal acid secretory rate produced by pentagastrin in 7 nonoperated and 6 vagotomized DU patients and in 5 healthy subjects. The heterogeneous secretory effects of maximal stimulus combination suggest that fundic distention has a complex action on acid secretion eliciting a hitherto unknown inhibitory effect as well as a cholinergic activation of the parietal cell area. This complex action may explain the failure of fundic distention to augment markedly the action of pentagastrin in the present study.

Adult↗
PubMed1977

Is there an oxyntopyloric reflex for release of gastrin in man?

Plasma gastrin concentrations and gastric acid output were measured during graded balloon distention of the gastric fundus and body in 20 patients with duodenal ulcer. Acid output rose stepwise with increasing distention volumes but plasma gastrin remained unchanged. During intragastric neutralization in 5 of these subjects, fundic distention did not elicit a significant rise in plasma gastrin, whereas the acid response was similar to that observed in the control study when the gastric contents were acid. In 8 of the 20 patients, proximal gastric vagotomy profoundly suppressed the acid response to fundic distention. Basal plasma gastrin concentrations were elevated after vagotomy but were unchanged during graded fundic distention. The results suggest that neural reflex activation of the oxyntic glands is the main mechanism by which fundic distention stimulates acid secretion in man. The failure of fundic distention to release gastrin does not, however, completely rule out the existence of an oxyntopyloric distention reflex for gastrin release in man. Fundic distention in man seems to both stimulate acid secretion and induce an inhibitory mechanism acting on acid secretion. This inhibitory mechanism may, purely speculatively, also mask the effect of an oxyntopyloric reflex for gastrin release. The present study and earlier work suggest that in man distention of the stomach is a poor stimulus for release of gastrin, regardless of whether the pyloric or the oxyntic gland area, or both, are distended.

Adult↗