Biomedical subjects

B Lembcke

Publications and source records attributed to B Lembcke.

At least 55 records · Page 3Linked to original sources

PubMed1996

Quantification of fecal carbohydrates by near-infrared reflectance analysis.

Established methods for quantitative analysis of fecal carbohydrates (CHO) are time consuming, require unpopular sample handling, and are therefore rarely performed. The aim of this study was to evaluate the efficiency, validity, and practicability of near-infrared reflectance analysis (NIRA), compared with standard methods for measurement of fecal CHO. Excretion of fecal CHO was cross- validated spectrophotometrically with the anthrone method. Fecal CHO concentrations ranged form 2.7 to 24.5 g/kg wet weight. Methods comparison showed linear regression over the entire range of diagnostic relevance with a correlation coefficient of 0.869 (S(y/x) +/- 0.31). Repeated measurements from the same stool collections obviated the need for homogenization. These results indicate that NIRA may be a new, reliable, and accurate test in the diagnosis of CHO malabsorption.

Adolescent↗

PubMed1996

[Measurement of fecal elastase 1 by immunoreactivity: a new indirect test of the pancreatic function].

AIM: The aim of this study was to evaluate the potential and precision of the fecal elastase type 1 rest in comparison to the secretin-pancreozymin-test in the diagnosis of exocrine pancreatic insufficiency. METHODS: We studied 254 stool samples from 102 individuals without malabsorption (n = 53) and patients with pancreatic maldigestion syndromes (n = 49). Pancreatic elastase was measured immunologically, using a new enzyme immunoassay according to the sandwich technique. RESULTS: Spot stool immunoreactive elastase activity in controls ranged from 136 to 4,400 micrograms/g. Ninety five percent of all values where within 175 to 1,500 micrograms/g. The lower limit of normal was defined as 150 micrograms/g. No significant decrease of immunoreactivity was found when stool samples were stored at room temperature over five days. The assay variability calculated from 10 consecutive assays of a single fecal sample gave coefficients of variation ranging from 3.3 to 6.3% for intraassay-variability and from 4.1 to 10.2% for interassay-variability. There was a good correlation between the output of elastase compared to lipase output with correlations coefficients of 0.821 in controls and 0.905 in patients with impaired pancreatic function. In stool samples of 49 patients with exocrine pancreatic insufficiency the concentration of fecal elastase was significantly lower (P < 0.001) compared to controls and patients with Crohn or coeliac disease. Elastase immunoreactivity showed higher sensitivity and specificity as compared to fecal chymotrypsin. Furthermore, in contrast to fecal chymotrypsin, the test results were unaffected by pancreatic enzyme replacement therapy. CONCLUSION: These results indicate that fecal immunoreactive elastase may be recommended as a new, non-invasive easy-to-perform tubeless pancreatic function test with a high sensitivity and specificity in comparison with healthy controls.

Adolescent↗

PubMed1996

Diagnostic intervals for recognizing celiac disease.

The aim of this retrospective study was to determine the time intervals between the onset of symptoms and diagnosis of celiac disease on the basis of a questionnaire that was published in the journal of the German Celiac Society (Verbandszeitschrift der Deutschen Zöliakie-Gesellschaft). 408 adult patients in whom the diagnosis of celiac disease was made after the age of 15 responded to the questionnaire. The time interval between the onset of symptoms and diagnosis (total diagnostic interval) was 5.4 (median) and 10.1 +/- 12.3 (mean +/- SD) years, interval-1 (time interval between the onset of symptoms and the first visit to a doctor) was 0.4 (median) and 2.2 +/- 6.6 (mean +/- SD) years, and interval-2 (time interval between the first visit to a doctor and the diagnosis) was 3.9 (median) and 8.0 +/- 10.4 (mean +/- SD) years. The time intervals shortened only a little over the years. At all times, interval-2 was significantly longer than interval-1. There were no differences between female (n = 328) and male (n = 80) patients and between the age groups. Furthermore, none of the gastrointestinal and non-gastrointestinal symptoms had had a distinct influence on all diagnostic intervals and also the fact that other family members having the disease did not shorten any of the intervals. In summary, the diagnostic intervals for recognizing celiac disease are still unacceptably long. More public awareness work has to be done so that patients can recognize their symptoms and doctors especially can suspect celiac disease sooner and perform the necessary diagnostic procedures when patients present with suggestive symptoms.

Adolescent↗

PubMed1996

[Esophagus and anorectal motility in patients with dysfunction of Oddi's sphincter].

Esophageal and anorectal motility have not been systematically evaluated in patients with sphincter of Oddi dysfunction (SOD). We have investigated 8 consecutive patients (6 females, 52.5 +/- 9.5 y) with type I-SOD (according to the Milwaukee-classification), 12 patients (9 females, 50.4 +/- 12.3 y) with type III-SOD, and 20 healthy volunteers (15 females, 48.5 +/- 15.2 y) by means of a standardized questionnaire for esophageal and anorectal symptoms, esophageal manometry, colonic transit time evaluation, and anorectal manometry. Symptom-scores did not differ significantly between type-I and type III-SOD-patients, respectively. Furthermore, there were no relevant differences of the symptom-scores of the SOD-patients vs. healthy subjects. However, the lower esophageal sphincter pressure (LESP) was significantly higher in patients with type I-SOD (26.8 +/- 7.4 mmHg) than in both, type III-SOD-patients (20.3 +/- 4.0 mmHg, p < 0.05) and healthy subjects (18.6 +/- 3.5 mmHg, p < 0.001), respectively. Mean colonic transit time did not differ significantly between both groups of patients (type I-SOD, 27.9 +/- 21.4 h, vs. type III-SOD, 28.5 +/- 15.1 h, p < 0.05). The anal sphincter resting pressure (ARP) was significantly higher in patients with type I-SOD (90.8 +/- 15.5 mmHg) than in healthy subjects (74.1 +/- 10.3, p < 0.01), but did not differ significantly from that in patients with type III-SOD (82.1 +/- 11.5 mmHg, p = 0.17). Computer-assisted "beat-to-beat"-evaluation showed an abnormal heart rate variability in 3/8 patients with type I-SOD. These results give evidence for a systemic involvement of the lower esophageal and the anal sphincter in patients with type I-SOD, which does not occur in patients with type III-SOD.

Adult↗

PubMed1995

Bioelectrical impedance analysis as a predictor of survival in patients with human immunodeficiency virus infection.

In patients with AIDS, short-term survival has been related to body weight, body composition, and serum nutritional parameters, but their prognostic impact at earlier stages of the HIV infection is not known. With an individual follow-up period of 1,000 days, we investigated the prognostic relevance of electrical tissue conductivity [resistance R, reactance Xc, phase angle alpha, extracellular mass (ECM), body cell mass (BCM)] measured by bioelectrical impedance analysis, of the CD4+ cell count, and of serum parameters indicating malnutrition in 75 HIV-infected male patients at Walter Reed stages 3-5. After initial recording, 29 patients (38.7%) died from AIDS during this period. Among 12 parameters estimated with a semiparametric Cox regression model adjusted for therapy (pentamidine, azidothymidine), the phase angle alpha (parameter estimate: -1.043, 95% confidence interval of -0.61 to -1.47; p < or = 0.0001), the ECM/BCM ratio, Xc, BCM, serum cholesterol, number of CD4+ cells, and serum albumin had significant prognostic influence on survival, whereas age, body weight, body mass index, resistance, serum protein, and serum triglycerides did not. In a model with four covariates (CD4+ cells, phase angle, pentamidine, azidothymidine), the prognostic impact of the CD4+ cell count (parameter estimate: -0.549) was lower compared with the phase angle alpha (parameter estimate: -0.799; p < or = 0.0001) and did not gain statistical significance (p = 0.0626). The phase angle alpha was the best single predictive factor for survival among all 12 parameters (comparison of the respective Cox models with the likelihood ratio test).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1995

Influence of cisapride on gastric emptying of solids and liquids monitored by 13C breath tests.

[13C]Acetate and [13C]octanoate breath tests were used to analyze the gastric emptying of liquids and solids in healthy controls and patients with functional dyspepsia both with and without cisapride. A standard test meal was labeled with either 150 mg [13C]acetate (liquid phase labeled in the water) or with 100 mg [13C]octanoate (solid phase labeled in the egg yolk). Six patients with dyspepsia and six healthy controls underwent a 4-hr breath test four times, ie, both the [13C]acetate and [13C]octanoate test with and without cisapride. Duplicate [13C]acetate or [13C]octanoate breath tests were performed in another 12 healthy controls in order to assess day-to-day variability of gastric emptying for liquids and solids. The mass spectrometric data were fitted to a power exponential function allowing mathematical analysis of half-emptying times and lag times. In patients with dyspepsia, gastric half emptying times of solids were significantly delayed as compared to the emptying of solids in the controls (203 +/- 41 vs 148 +/- 35 min; P < 0.05). With cisapride, gastric emptying of solids was significantly accelerated (P < 0.05) both in the patients (166 +/- 58 min) and in the controls (117 +/- 27 min). The gastric emptying of liquids did not differ in patients and controls, and cisapride had no effect on the emptying of liquids within the normal range. In the healthy controls, half emptying times both for liquids and solids were reproducible on the two different days (CVintra: 5.58% for liquids, 20.01% for solids).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetates↗

PubMed1995

The [13C]acetate breath test accurately reflects gastric emptying of liquids in both liquid and semisolid test meals.

BACKGROUND/AIMS: The current standard for gastric emptying studies are radioactive isotope methods. [13C]breath tests have been developed as a nonradioactive alternative. The aim of this study was to validate a [13C]acetate breath test as a measure of gastric emptying of the liquid phase both in liquid and semisolid test meals by simultaneous radioscintigraphy. METHODS: Thirty-five patients with dyspeptic symptoms and 20 healthy volunteers were tested using a semisolid oatmeal or a liquid test meal. Both test meals were labeled by 150 mg sodium [13C]acetate and (in patients) by 45 MBq 99mTc-albumin colloid. Half-time of gastric emptying was calculated after curve fitting of the 13C exhalation to a modified power exponential function. 99mTc-albumin emptying was measured by conventional radioscintigraphy. RESULTS: The half-emptying times for the [13C]acetate breath test closely correlated to those measured by radioscintigraphy both for semisolids (r = 0.87) and liquids (r = 0.95). The time of maximum 13CO2 exhalation was itself a reliable parameter compared with the half-emptying times obtained by scintigraphy (r = 0.85 for semisolids; r = 0.94 for liquids). CONCLUSIONS: The [13C]acetate breath test is a reliable and noninvasive tool for the analysis of gastric emptying rates of liquid phases without radiation exposure.

Acetates↗

PubMed1995

Pneumatic dilation in achalasia with a low-compliance balloon: results of a 5-year prospective evaluation.

To evaluate long-term efficacy and side effects after pneumatic dilation with low-compliance balloons, 40 patients with achalasia were prospectively studied during a 5-year period. All patients were investigated before, 4-6 weeks after, and at 28 +/- 15 months (final visit) after pneumatic dilation. Additionally, 12 patients underwent 24-hour esophageal pH-metry before and 26 +/- 14 months after dilation. Initial symptomatic success was obtained in 35 of 40 patients (87.5%). The remaining five and another seven patients with recurrent dysphagia underwent a second dilation, and two of these patients finally underwent esophagomyotomy. Effective dilation was reflected by a significant decrease of the symptom scores (p < 0.01) and an increase of the gastric cardia diameter both at 4-6 weeks after dilation and at the final visit (p < 0.01). Dilation reduced the lower esophageal sphincter pressure from 28.3 +/- 0.8 mmHg to 16.4 +/- 6.4 mmHg at the 4-6 weeks exam and to 14.7 +/- 5.5 mmHg at the final visit, respectively (p < 0.01). Neither the diameter of the esophageal body nor the motility of the tubular esophagus was affected by pneumatic. Esophageal pH-metry showed an increase of the number and duration of reflux episodes (pH < 4) after dilation (p < 0.05), whereas only one patient reported heartburn and another asymptomatic patient revealed esophagitis I0 at endoscopy. Therefore, pneumatic dilation with low compliance balloons proved to be safe and long lasting treatment of achalasia. Although prolonged esophageal acid exposure was measurable after dilation, clinically relevant gastroesophageal reflux occurred in only 5% (n = 2).

Catheterization↗

PubMed1995

Does pre-treatment with bile acids enhance efficacy of biliary extracorporeal shock wave lithotripsy?

To determine the effect of chenodiol and ursodiol pre-treatment prior to shock wave lithotripsy of gallstones, two groups of 50 gallbladder stones (n = 100), obtained at cholecystectomy, were matched according to their size, shape and weight. All stones were stored in a bile perfused gallbladder model for two weeks. In the first group (A), serving as control, native bile was used, whereas in the other group (B), ursodiol- and chenodiol-enriched bile was perfused, both bile acids at therapeutic concentrations. After two weeks of pre-treatment, electromagnetic shock wave lithotripsy (19 kV, 1 Hz) was performed until stones were fragmented to a size smaller 2 mm. Neither stone density, as assessed by computed tomography, nor their cholesterol content were different in group A and B. A trend towards higher fragmentation efficacy was observed for stones < 15 mm and for those with a CT-density < 100 HU. No influence of either stone shape (rounded vs. angular) or cholesterol content was observed with regard to fragmentation efficacy. Comparing the number of shock waves (SW) required for fragmentation (< 2 mm) there was no significant difference between group A (1850 +/- 1300 SW) and group B (1970 +/- 1500 SW, n.s.). These in vitro results do not support a significant role of bile acids as a rationale pre-treatment prior to lithotripsy of gallstones.

Absorptiometry, Photon↗

PubMed1995

Effect of endoscopic sphincterotomy on sphincter of Oddi manometry results in patients with or without papillary stenosis.

Patients with fibrotic papillary stenosis (PS) are at high risk for sphincter of Oddi-re-stenosis after endoscopic sphincterotomy (ES). Therefore, a prospective trial was conducted to assess the acute and long-term effects of ES on sphincter of Oddi motor function in patients with papillary stenosis. The immediate effects of ES were studies by endoscopic manometry in 12 patients with PS, and in 15 patients with common bile duct stones (CBDS, control group). Furthermore, after a median follow-up of 15 months, 11 from those 12 patients with papillary stenosis were reinvestigated with ERCP and manometry. Complete ES (defined by a common bile duct pressure and a basal sphincter of Oddi-pressure (BSOP) < 5 mm Hg) was achieved in 13/15 CBDS-patients, but only in 3/12 patients with PS (p<0.01), although sphincterotomy was extended to the maximal length as judged endoscopically. Four patients with PS had a residual BSOP > 20 mm Hg. However, all patients with PS became symptom-free immediately after ES. The phasic sphincter motility was not affected significantly different in both groups of patients (p = 0.25). Those patients with a residual BSOP > 20 mm Hg after ES developed sphincter of Oddi-re-stenosis during the follow-up (3 patients) or revealed re-stenosis at the control examination after follow-up (1 patient). After the follow-up manometrically defined complete sphincterotomy was furtheron demonstrable in only 2/11 patients with papillary stenosis. In conclusion, ES revealed a decreased efficacy to eliminate the sphincter of Oddi motor function in a substantial number of patients with papillary stenosis. This may explain the remarkably high rate of sphincter of Oddi-re-stenosis after sphincterotomy in these patients.

Adult↗

PubMed1994

[Simple tests for small intestinal function].

Simple tests of small intestinal function not only allow to verify and quantitate malabsorption syndromes, but also permit to make first differential diagnostic decisions which in turn allow to employ more invasive or elaborate techniques on a more rational and restricted base. Essential diagnostic procedures comprise the analysis of fecal wet weight, fecal fat excretion, occasionally of serum beta-carotene concentration, the D-xylose test, the breath-hydrogen test with either lactose or glucose as substrates, the detection of bile acid malabsorption with 75Se-HCAT and of protein-loosing enteropathies by means of the fecal clearance of alpha-1-antitrypsin.

Breath Tests↗

PubMed1994

[Chronic constipation--what to do?].

Chronic constipation implicates heterogeneous disturbances of colonic transit and defecation which require both, careful medical evaluation and therapy. While the modes of action and side effects of laxatives are known for years, the understanding of dysfunctions underlying chronic constipation appears to be related to the understanding of subtle and new investigative techniques. This and the former extent of laxative prescriptions may explain why (based on an 'ex cathedra' decision by the governmental and insurance companies) the prescription of laxatives among primary care practitioners (in Germany) is not acknowledged as medical therapy. How to continue? First: two steps back, reestablishing understanding of constipation as a disease, including subtle diagnosis and differential diagnosis; then; two steps ahead, towards specific therapy, being aware that the available drugs are effective and require prescription by an experienced physician.

Cathartics↗

PubMed1994

Polyserositis in adult Still's disease with onset during pregnancy [corrected].

We report about a 25-year-old female patient, who met all the criteria of adult-onset Still's disease except for the typical nonpruric rash. The disease exacerbated during pregnancy. Polyserositis was the predominant clinical manifestation. The histological examination of the bone marrow biopsy revealed changes similar to those seen in a myelodysplastic syndrome. The clinical condition improved after therapy with high-dose steroids and cyclophosphamide.

Abortion, Therapeutic↗

PubMed1994

Clinical evaluation of a miniaturized desktop breath hydrogen analyzer.

UNLABELLED: A small desktop electrochemical H2 analyzer (EC-60-Hydrogen monitor) was compared with a stationary electrochemical H2 monitor (GMI-exhaled Hydrogen monitor). RESULTS: The EC-60-H2 monitor shows a high degree of precision for repetitive (n = 10) measurements of standard hydrogen mixtures (CV 1-8%). The response time for completion of measurement is shorter than that of the GMI-exhaled H2 monitor (37 sec. vs 53 sec.; p < 0.0001), while reset times are almost identical (54 sec. vs 51 sec. n.s). In a clinical setting, breath H2-concentrations measured with the EC-60-H2 monitor and the GMI-exhaled H2 monitor were in excellent agreement with a linear correlation (Y = 1.12X + 1.022, r2 = 0.9617, n = 115). With increasing H2-concentrations the EC-60-H2 monitor required larger sample volumes for maintaining sufficient precision, and sample volumes greater than 200 ml were required with H2-concentrations > 30 ppm. CONCLUSION: For routine gastrointestinal function testing, the EC-60-H2 monitor is an satisfactory and reliable, easy to use and inexpensive desktop breath hydrogen analyzer, whereas in patients with difficulty in cooperating (children, people with severe pulmonary insufficiency), special care has to be applied to obtain sufficiently large breath samples.

Adult↗

PubMed1994

Clinically feasible stable isotope technique at a reasonable price: analysis of 13CO2/12CO2-abundance in breath samples with a new isotope selective-nondispersive infrared spectrometer.

Up to now, stable isotope analysis of carbon dioxide in breath samples is carried out with sensitive but very expensive and complex isotope ratio mass spectrometry (IRMS). Aiming at a more widespread application of breath tests in gastroenterological diagnostic routine, we tested a newly developed isotope selective non-dispersive infrared spectrometer (NDIRS) in comparison to IRMS. 13C-urea breath tests were performed in 63 patients as the routine screening method for Helicobacter pylori infection. Breath samples at baseline and (15) 30 min after administration of the test solution containing 13C-urea were analysed both by NDIRS and conventional IRMS. The correlation between the delta values of both devices was linear and in good agreement (r = 0.96; p < 0.0001; Y = 1.01 X -0.94). Comparing the delta over baseline-values, the correlation was Y = 1.11 X -0.36 (r = 0.98; p < 0.0001). Referring to the diagnosis of Helicobacter pylori infection with IRMS we calculated a sensitivity of 95.0% and an unchanged specificity (100%) for NDIR analysis. In conclusion, NDIRS appears a promising, easy to operate, and low cost potential alternative to conventional IRMS thus encouraging further detailed investigation and more widespread application of the noninvasive stable isotope technique in breath tests for gastrointestinal function testing.

Adolescent↗

PubMed1994

Lack of accuracy of plasma alpha-amino nitrogen profiles as an indicator of exocrine pancreatic function both after continuous and bolus stimulation of the pancreas with secretin and cholecystokinin-pancreozymin.

BACKGROUND: The reduced decrease of plasma alpha-amino nitrogen after hormonal stimulation of the pancreas has been characterized as a valid and simple test of pancreatic function. Aim of this study was to reassess the clinical value of the alpha-amino nitrogen test and to evaluate the role of different modes of hormonal secretion. Therefore, we have investigated the relationship of plasma alpha-amino nitrogen responses and pancreatic secretion, stimulated by either bolus injection (n = 25) or continuous infusion (n = 32) of cholecystokinin-pancreozymin in patients with and without exocrine pancreatic insufficiency as determined by the secretin-pancreozymin test. Of the 57 patients referred to the secretin-pancreozymin-test, 18 had pancreatic insufficiency, each 9 in the group with continuous and bolus stimulation. RESULTS: Basal alpha-amino nitrogen concentrations were almost identical in patients with and without impaired pancreatic function (2.66 +/- 0.12 mmol/l vs. 2.73 +/- 0.08 mmol/l [SEM]; p > 0.05). Both, the bolus dose and infusion of cholecystokinin induced similar (log-normally distributed) maximum decreases of alpha-amino nitrogen concentrations (-SD; mean; + SD: 3.6; 9.0; 22.3% vs. 6.0; 10.5; 18.5%, respectively) in the patients without exocrine pancreatic insufficiency. This was in tendency more pronounced compared to those with impaired pancreatic secretion (cholecystokinin bolus; 2.7; 5.2; 9.9%; infusion: 5.0; 7.7; 11.6%). The difference (+/- exocrine pancreatic insufficiency) was significant (p < 0.05) for the infusion mode only. Moreover, the time course of alpha-amino nitrogen concentration-profiles was more homogenous after hormone infusion as compared to bolus stimulation. Sensitivities to detect exocrine pancreatic insufficiency by the alpha-amino nitrogen test were < 50% with either test modification. CONCLUSION: The decrease of plasma alpha-amino nitrogen after stimulation with cholecystokinin is no accurate indicator of exocrine pancreatic function, regardless of whether hormonal stimulation is by bolus or by infusion.

Adult↗

PubMed1994

[Diagnostic and therapeutic possibilities in suspected Oddi's sphincter dysfunction].

Endoscopic manometry and quantitative cholescintigraphy are the diagnostic cornerstones for the detection of suspected sphincter of Oddi dysfunction. In patients with recurrent biliary pain after cholecystectomy, endoscopic manometry proves an elevated sphincter of Oddi baseline pressure as the most common finding. The probability for the detection of an elevated baseline pressure in these patients is significantly correlated with the presence of certain clinical features (i.e. biliary pain and/or cholestasis and/or dilated bile duct and/or delayed drainage of contrast material after ERCP). Therefore, these features enable a clinical classification of patients with suspected sphincter of Oddi dysfunction. Isolated baseline pressure elevations in the pancreatic portion of the sphincter of Oddi were reported in patients with recurrent, idiopathic, acute pancreatitis. In patients with biliary sphincter dysfunction, therapeutic relief can be expected from pharmacological therapy, but controlled studies are lacking. However, the clinical value of endoscopic sphincterotomy could be established in this field. Despite endoscopic manometry is not a prerequisite for the performance fo endoscopic sphincterotomy in every case of suspected sphincter of Oddi dysfunction, in most patients endoscopic manometry allows the only definitive diagnosis of sphincter dysfunction. Further on, the clinical value of semi-invasive methods as alternative treatment strategies (i.e. botulinum-toxin, transcutaneous electric nerve stimulation, balloon dilation) for sphincter of Oddi dysfunction has to be evaluated in the future.

Acute Disease↗

PubMed1994

More convenient 13C-urea breath test modifications still meet the criteria for valid diagnosis of Helicobacter pylori infection.

AIMS AND METHODS: 13C-Urea breath tests (UBT) were performed in 217 patients with epigastric symptoms to assess (a) the validity of shorter intervals of breath sample collection and (b) of the non-fasting state on diagnosing H. pylori infection and to evaluate (c) a more simple sampling method. (a) In 186 patients, breath samples were taken before and at 10, 20, 30, 40, 50, 60, 90, and 120 minutes after ingestion of 75 mg 13C-urea. 13C-enrichment was measured by isotope ratio mass spectrometry [delta/1000] and the cumulative recovery rate (CRR) was calculated. (b) 31 patients performed 13C-UBTs on two occasions, i.e. fasted and in the postprandial state collecting breath before and 30 min after substrate ingestion. (c) 61 breath samples were obtained in duplicate, i.e. both with an aluminium foil breath bag using evacuated glass tubes, and by exhalation into open vials via straw. RESULTS: (a) DOB-responses at 10, 20, 30, and 40 minutes after dose showed a linear correlation with the 120 min-CRR. Referring to a CRR > 3% at 120 min (criterion of H. pylori-infection), DOB-responses at 20 min with a cut off-value at 5/1000 (ROC-analysis) were shown to be valid for diagnosing H. pylori status in man (sensitivity 99.0%, specificity 100%). (b) Postprandially, mean DOB-responses of H.pylori positive patients were lower than in the fasting state (17.46/1000 vs. 27.63/1000; p < 0.01). With the cut-off at 5/1000, however, sensitivity still was 94.4% and specificity was 100%. (c) The straw and breath bag method gave equivalent results (r = 0.98, p < 0.0001). CONCLUSIONS: (a) A two sample measurement using the DOB at 20 min and a cut-off value of 5/1000 can replace the CRR-calculation over 120 minutes. (b) Although quantitative DOB-responses are significantly affected, 13C-UBT can be performed in the postprandial state with no significant effect on the detection of the H. pylori infection. (c) The sample collection by a simple straw method meets precision requirements < 1.5 delta/1000. Thus, the 13C-UBT can be performed cheaper, faster and more conveniently.

Adult↗