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Biomedical subjects

W Schellerer

Publications and source records attributed to W Schellerer.

At least 19 recordsLinked to original sources
PubMed1980

Effects of cimetidine upon gastric secretion and mucosal blood flow in the rat stressed by restraint. A dose-response and prophylaxis trial.

The effect of the histamine-H2-receptor blocking agent cimetidine (CT) on gastric secretion, mucosal blood flow (MBF), and gastric mucosal stress ulcer index was studied in rats (n = 96) during control conditions (3.9, 15.6, 62.4 microMol/kg/h CT i.p. over 8 h) with calculation of kinetic constants (Vmax; Km) for gastric secretion, MBF and ulcer index, it is shown that CT actions become considerably modified by severe stress. Under mild stress the reduction of MBF and acid secretion by increasing CT doses is parallel. Severe stress alone reduces MBF more than gastric acid (65 vs. 30%). This phenomenon is partly reversed by a dose of 62.4 microMol/kg/h (= 16 mg/kg/h), which is associated with the lowest ulcer index observed. There is no significant correlation between the latter and either acid concentration, acid output, or MBF. The concentrations of pepsin in gastric juice or of serum gastrin neither change with severe stress alone or with additional CT. It is concluded that CT has anti-stress ulcer properties coinciding with reduced acidity in the gastric lumen, but that in addition this beneficial effect may be mediated by factors other than acid reduction.

Animals↗
PubMed1980

Fasting blood values of glucose, insulin, glucagon, gastrin following highly selective vagotomy in duodenal ulcer patients.

Changes in fasting blood levels of glucose, insulin, glucagon and gastrin were determined in duodenal ulcer patients (n equal to 59) before and up to 1 year after highly selective vagotomy (HSV). There was an increase in glucose values after HSV by approximately 6 mg/dl. The rise in gastrin levels was variable depending on the maximal preoperative acid secretion during pentagastrin stimulation. Insulin values remained unchanged after HSV while there was a significant drop of glucagon levels after 1 year. There is no relationship between the extent of post-HSV gastrinemia and glucose or between the latter and glucagon. It can be assumed that HSV causes additional metabolic changes besides reducing acid production.

Adolescent↗
PubMed1980

Gastrinemia, serum minerals and calciotropic hormones following highly selective vagotomy in duodenal ulcer patients. Results of a 1-year study.

Duodenal ulcer patients with normal (n = 36) or increased (n = 24) gastric acid production during maximal pentagastrin stimulation, were examined preoperatively and at different intervals (up to 1 year) after highly selective vagotomy (HSV). Fasting levels of gastrin, parathormone, calcitonin, proteins, calcium and magnesium fractions, inorganic phosphate and alkaline phosphatase were determined in serum, those of glucagon in plasma. Both types of patients have the same gastrin levels preoperatively (approx. 36 pg-equiv./ml). Magnesium and alkaline phosphatase are significantly higher in patients with a normal secretory response than in those with hypersecretion. The postoperative gastrin increase is significantly higher in the former than in the latter, while postoperative glucagon levels drop in both groups. The analysis of calcium fractions and the dissociation constant did not show any HSV-mediated change in calcium metabolism. The magnesium levels, however, are lower one year after the operation than in the pre-operative period in patients with normosecretion. In this group parathormone and calcitonin remain unchanged while in patients with a hypersecretory response a slight (parathormone) or moderate (calcitonin) tendency towards low values can be recognized in the post-operative period. We conclude that the duodenal ulcer patients probably belong to groups with different pathophysiological behaviour which do not have identical reactions to HSV. Imbalances in the metabolism of minerals and that of related hormones could not be demonstrated up to one year after HSV.

Adult↗
PubMed1978

[Primary healing of the sacral cavity after proctectomy - a solvable surgical problem (author's transl)].

Primary healing of the perineal wound and the sacral cavity after a.p. resection of the rectum is an old surgical problem. In order to achieve primary healing we are using a lengthened omental graft to fill up the sacral space. Since January 1977 to July 1977 we used this method in 17 patients. 15 patients had very low rectal cancers. 2 patients had to undergo proctocolectomy because of ulcerative colitis. In 14 cases we achieved primary healing, among these the colitis patients. Overall we had three abscess formations in the sacral cavity. One of these patients got in addition an obstruction postoperatively.

Abscess↗
PubMed1978

[Evaluation of renal cyclic adenosine monophosphate, serum parathyroid hormone and phosphate reabsorption in recurrent calcium urolithiasis, healthy controls and hyperparathyroidism (author's transl)].

In three groups (n = 12 each) of male controls (22--43 years), patients with recurring calcium urolithiasis (21--36 years) and hyperparathyroidism (HPT; 17--71 years) proven by surgery renal cyclic adenosine monophosphate (RcAMP), fractional tubular phosphate reabsorption and serum parathyroid hormone (PTH) were measured during endogenous creatinine clearance. RcAMP (muMol/g creatinine) was: controls 1.48 +/- SEM 0.27; stone formers 2.037 +/- 0.343 (not significantly different); HPT 6.234 +/- 0.454 (p less than 0.001). There is no overlap between HPT and controls. Phosphate reabsorption is least in HPT (0.84 +/- 0.015), higher in controls (0.924 +/- 0.004) and stone formers (0.941 +/- 0.007). All differences are statistically significant. Under the conditions selected (moderate hydration of individuals) Serum PHT (pg-equiv/ml) is lowest in stome formers (less than 100--339), higher in controls (less than 100--933) and HPT (400--1150). there is no overlap in PHT between the former and the latter group but a marked one between controls and HPT. For clinical purposes the resulting diagnostic uncertainty in a given patient can be overcome by additional determinations of RcAMP and ionised serum calcium: when referring to serum PTH HPT patients fall outside, RCU patients within 2 standard deviations of either parameter in control subjects. This procedure presently appears superior to those proposed in the past (urinary cAMP etc.) but requires confirmation in larger patient populations. Moreover, since HPT prevails in middle and upper age decades, their RcAMP values and those of RCU patients should be related to a range seen in closely age- and sex-matched controls.

Adult↗
PubMed1978

[Rectoscopic diagnosis of the height of rectal carcinoma (author's transl)].

In 100 excisions of the rectum at the Chirurgische Universitätsklinik Erlangen the height of the tumor determined preoperatively by rectoscopic diagnosis was compared directly to the real tumor location of the fresh and unfixed specimen. In up to 58% of the cases we found a distinct discrepancy between the height determined rectoscopically and the real location of the tumor. This result shows that the decision between excision and resection must never be made on the preoperative rectoscopic information, but that the indication must always depend on the intraoperative findings. This is especially true for the disputed cases of the middle third of the rectum.

Adult↗
PubMed1978

[Practical management of parenteral nutrition (author's transl)].

Three different plans of parenteral nutrition are available: (1) postoperative water and electrolyte substitution; (2) basic parenteral nutrion; (3) total parenteral nutrition. The decision for one of these plans depends on the duration of necessary parenteral support and on the patient's situation. ad 1: solution with electrolytes, 40 ml/kg body weight/day ad 2: solution with electrolytes, amino acids (25 g/day) and carbohydrates (125 g/day) in a 75 kg patient ad 3: solution with electrolytes, amino acids (1 g/kg body weight/day) and carbohydrates (5 g/kg body weight/day).

Amino Acids↗
PubMed1977

[Continence after low anterior resection (author's transl)].

In 28 patients we studied the fecal continence after low anterior resection of the rectum. After an usual proctological investigation we did in all patients measurements of the anorectal function, such as pressure measurement, electromyography and determination of the anal-rectal angle. In 12 patients a defecatogram was performed. Of the 28 patients with anastomoses lower than 8 cm only one was after 2 years still incontinent. All the other patients were completely continent. This fact could be proven objectively.

Adult↗
PubMed1977

[Evaluation of H2 receptor blockade with metiamide in stress ulcers in rats].

Restrain stress in rats inhibits gastric secretion and microcirculation. Secretion is further inhibited by metiamide, but mucosal blood flow is restored to normal. During stress the ulcer incidence is high, lower with prophylactic administration of metiamide and least with the latter and preserved gastroduodenal acid transit. No therapeutic metiamide effect can be detected.

Aminopyrine↗
PubMed1977

Anti-stress ulcer and anti-secretory effect of somatostatin in rats -- failure to suppress serum gastrin.

In rats the influence of arresting free motions (= controls; mild stress) and of restraint (= severe stress) without and with additional somatostatin (SRIF) on gastric secretion, mucosal microcirculation and stress ulcer formation was studied. Severe stress alone reduces volume, acid and pepsin secretion, acid concentration, aminopyrine clearance and ratio. The ulcer index is elevated. Under both conditions SRIF inhibits in a dose-dependent manner volume and acid secretion, and ulcer incidence is lower. The interaction between severe stress and the antiulcer component of SRIF is characterized as non-competitive. Under these conditions and a continuous infusion of SRIF (10.0 microgram/kg.h over 8 h) acid concentration, acid and pepsin secretion fall subtotally, ulcer index to 50 percent of vehicle (saline) treated rats, if gastric fistula drains juice outside stomach. Microcirculation and serum gastrin are unchanged. In animals with closed fistula ulcer index is reduced by 85 percent, average gastrin again is unchanged. It is concluded that stress ulcers develop at a low secretory and microcirculatory state of gastric mucosa. The prophylactic effect of SRIF results from direct inhibition of parietal and chief cells and additional yet unknown factors.

Animals↗
PubMed1977

[Survival time and life quality after operative treatment of colonic cancer (author's transl)].

In regard to other intestinal malignomas colon cancer shows the chance of a long survival time. In cases of stage Dukes A and B the patient has a 5 year survival time of 100 to 82% depending on his age. In carcinoma of the rectum preoperative biopsy is necessary. In cases with grade III we prefer the exstirpation. The Erlangen magnetic closure of the colostomy gives continence in 70%.

Colonic Neoplasms↗
PubMed1976

[The outcome of conservative treatment of diverticular disease (author's transl)].

Patients with diverticular disease should be categorized for therapeutic purposes into 3 groups: (1) asymptomatic diverticulosis (accidental finding; (2) painful diverticular disease (no inflammation); and (3) acute diverticulitis (pericolitis present). In asymptomatic diverticulosis a high-fiber diet should be given, and an operation is not indicated. In painful diverticular disease resection of the sigmoid colon should be considered after recurrent attacks. In acute diverticulitis resection should be performed after the second inflammatory attack. The younger the patient, the earlier an operation should be considered.

Acute Disease↗
PubMed1976

Rat gastric mucosal oxygen tension, ulcer index, plasma gastrin and glucagon following restraint stress. Influence of vagotomy, splanchnicotomy and exogenous secretin.

Restraint stress ulcers in rats were developed and procedures evaluated designed at preservation of intact gastric microcirculation (pO2). Neither prior truncal vagotomy, splanchnicotomy nor combined dissection of abdominal autonomic nerves were effective in preventing the stress mediated fall of mucosal pO2 and the rise in plasma glucagon. The ulcer index remained elevated and gastrin essentially was unchanged. Prophylactic injection of increasing doses (1, 2, 4, 8, 16 U/kg secretin maintained microcirculation at pO2-levels subnormal for unstressed animals (Vmax 15.53 mm Hg; Km. 0.99 U/kg), but simultaneously brought about a continuous rise in serum gastrin. Up to 8 U/kg plasma glucagon was higher than in saline control groups reaching a peak value with 2 U/kg when ucler index showed its nadir. Secretin therapy (4, 8 U/kg) markedly improves both mucosal pO2 and ulcer index. It is suggested that breakdown of gastric microcirculation may not be solely responsible for stress ulcer development.

Animals↗
PubMed1976

[Calcium in the prevention of stress ulcer in the rat].

Calcium gluconate, carbonate, and lactate are potent antiulcerogenic agents when administered intragastrically at pH 6.3 by sustained infusion (45 mg/kg/8 h). In intact rats, by radioimmunologically measurable serum, gastrin and calcitonin are inversely correlated, whereas gastrin and ulcer index tend to correlate directly. The findings imply a key role for thyroid-releasable endogenous calcitonin in this disorder.

Animals↗