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Biomedical subjects

C Sieber

Publications and source records attributed to C Sieber.

35 records · Page 2Linked to original sources

Intestinal phase of superior mesenteric artery blood flow in man.

Duplex ultrasound was used to investigate superior mesenteric artery haemodynamics in humans in order to study the contribution of the small intestine to the postprandial splanchnic hyperaemia, and to determine the relative potencies of the major food components in the postprandial mesenteric flow response. Duplex parameters of vessel diameter, mean velocity, and volume flow were determined serially in the basal state and after stimulation. Flow parameters were significantly (p less than 0.05) increased after liquid and solid oral meals. Modified sham feeding did not alter mesenteric blood flow. Intestinal perfusion of an isocaloric liquid test meal induced flow increases comparable with oral intake. Superior mesenteric artery blood flow also significantly (p less than 0.05) increased after isocaloric and iso-osmolar loads of intraduodenal carbohydrate, fat, and protein meals. Responses were similar after the test meal, fat, and protein, but were significantly (p less than 0.05) less for carbohydrates. Different osmolar loads of saline did not affect flow responses. We conclude that the intestinal phase is the major regulator of the postprandial mesenteric blood flow response in healthy humans and that the chemical nature of food determines the mesenteric response pattern.

Adult↗

Regulation of postprandial mesenteric blood flow in humans: evidence for a cholinergic nervous reflex.

Duplex ultrasound was used to investigate superior mesenteric artery haemodynamics in humans in order to determine the physiological importance of postprandial blood concentrations of cholecystokinin octapeptide (CCK8), gastrin 17, secretin, and glucagon and to study whether a nervous cholinergic reflex mechanism has a role in the postprandial mesenteric blood flow response. Duplex parameters of vessel diameter, mean velocity, and flow volume were determined serially in the basal state and after stimulation. Changes were compared with baseline values. Superior mesenteric artery parameters were significantly increased over baseline values after a liquid test meal, but ingestion of saline did not cause any changes. Hormones infused simultaneously at postprandial concentrations did not change mesenteric blood flow. When they were infused at pharmacological doses, however, a significant increase in flow parameters was observed. Pretreatment with atropine significantly (p less than 0.05) reduced the mesenteric blood flow response to meal stimulation (57%). These data suggest that the four hormones tested are not of quantitative importance in regulating postprandial superior mesenteric artery blood flow. A cholinergic nervous reflex, however, participates in the control of food induced mesenteric artery flow changes.

Adult↗

[Hemiparesis and torsade de pointes under low-dose sotalol therapy].

An 81-year-old woman with recurrent epileptic attacks, hemiparesis and rapidly changing consciousness is described in whom the most probable reason for the clinical picture was polymorphous ventricular tachycardia (torsade de pointes). Sotalol (Sotalex), which the patient received for two weeks at a dose of 80 mg twice daily because of asymptomatic ectopic ventricular beats, was identified as the causative agent. Torsade de pointes disappeared after a single intravenous injection of 2 g magnesium sulfate. The patient left the hospital a few days later completely recovered from all neurological deficits.

Aged↗

A physiologic role for somatostatin 28 as a regulator of insulin secretion.

Somatostatin 28 (S-28) is a peptide produced in the intestinal tract which rises in the circulation during nutrient absorption. We tested the hypothesis that S-28 regulates B-cell function by (a) studying the effects on insulin secretion of "physiologic" infusions of S-28 and (b) measuring insulin responses during elevated nutrient-stimulated endogenous S-28 levels. (a) Synthetic S-28 was infused on separate days into six healthy men at rates of 25 and 50 ng/kg per h which mimicked postprandial levels. Subjects were given a bolus of glucose (0.1 g/kg) after 120 min. Insulin responses during S-28 infusions were compared to a control study using a saline infusion in the same individuals. Glucose-stimulated insulin secretion was inhibited during the infusion of 50 ng/kg per h S-28 when compared to control (P less than 0.05). (b) Insulin secretion during elevations of endogenous S-28 was studied in healthy men who received a bolus of 2.5 g arginine (n = 14) or 25 U of secretin (n = 8) 120 min after swallowing 50 g fat, or, on a separate day, an equivalent volume of water. S-28 levels rose significantly after fat ingestion but did not change after water. Arginine and secretin-stimulated insulin secretion was inhibited following ingestion of fat compared with intake of water (P less than 0.05). Arginine-enhanced glucagon secretion was not changed by fat ingestion. We conclude that elevations in plasma S-28 levels, occurring during the postprandial state, attenuate B-cell secretion and this peptide may be a physiologic modulator of nutrient-stimulated insulin release.

Administration, Oral↗

Effect of a new somatostatin analogue SMS 201-995 (Sandostatin) on the renin-aldosterone axis.

The effects of a new somatostatin analogue SMS 201-995 (H-D-Phe-Cys-Phe-D-Trp-Lys-Thr-Cys-Thr(ol), Sandostatin) on the orthostatic stimulation of plasma renin activity (PRA) following head-up tilting and on angiotensin II (Ang-II) induced aldosterone (PA) release were studied under placebo controlled conditions in separate groups of healthy volunteers consisting of six and 10 subjects, respectively. Head-up tilting (by 60 degrees) produced the characteristic increases in PRA and PA. Administration of SMS 201-995 significantly (P less than 0.05) inhibited this PRA elevation from 30 min on. Throughout the study period, PA levels were not consistently altered by this analogue. Furthermore, SMS 201-995 failed to inhibit the stimulation of PA secretion induced by exogenous angiotensin-II (2-10 ng/kg/min). Results presented here are at variance with data collected with natural somatostatin showing an inhibitory effect on stimulated PA. This discrepancy can be explained by the recently described absence of SMS 201-995 binding sites in primate adrenal cortex and in human aldosteronomas.

Adult↗

[Cadaveric kidney transplantation in patients over 55 years].

The progress of 24 patients aged over 55 who received kidney transplants from dead bodies is compared with that of 42 recipients aged under 55. The functioning of the transplants and mortality do not differ in the two groups 3 and 12 months after transplantation. However, in the group of older transplant patients we found a high incidence of analgesic nephropathies, twice as many associated cardiac complications and an increased incidence of tumours. It seems no longer justifiable to withhold such kidney transplants from patients over 55 on grounds of age.

Adult↗