Biomedical subjects
Publications and source records attributed to E Hanisch.
Following portocaval anastomosis a high lethality (87%) can be observed in a standardized micronodular liver cirrhosis model. By a special preoperative regimen this lethality can be reduced to 10%.
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Between October 1984 and June 1987 in 45 patients (9 males, 36 females) pre- and postoperatively the immunocompetent cells in the peripheral blood were measured using OKT- and LEU-11-antigens. 20 patients suffered from malignant and 25 patients from benign diseases. For statistical analysis, H-test according to Kruskal and Wallis was used. Preoperatively, the total account of T-lymphocytes was decreased in patients with thyroid carcinomas, but showed no differences compound to patients with benign diseases postoperatively. No differences were observed in lymphocytic subpopulations in all groups. Parallely, in 50 patients (14 males, 36 females) immunocompetent cells were counted in the resected specimens. There were investigated 29 carcinomas and 21 benign thyroid lesions using the LEU-antigens. Between the group with malignant diseases and that with benigne lesions of the thyroid, no statistically significant differences were observed.
56 children of the age of 1 month to 16 years were treated between 1970 and 1987 for pathological changes of the thyroid gland. In 29 patients the disease presented as a nodular goitre, in 13 as hypothyrosis and cysts, and in 5 as carcinoma. Subtotal resection was performed in a total of 18 cases; rectolateral resection was performed 13 times. In 7 children the left thyroid lobe was resected subtotally and enucleation was performed 13 times. The surgical procedure during the individual disease patterns is discussed.
Isolated supraclinoid occlusive disease of the internal carotid artery is a rare cause of cerebral ischemia. The authors of the only review of this subject concluded that it is caused predominantly by factors other than atherosclerosis. We examined 6 patients with isolated supraclinoid occlusive lesions. Five of them had one or more risk factors for atherosclerosis. Thus, the isolated stenosis of that part of the internal carotid artery does not seem to represent a particular pathologic entity.
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The effects of surgical and chemical sympathectomy on various gastric functions was studied in rats. From the results it is concluded that the sympatho-adrenal system inhibits gastric acid secretion and mucosal blood flow. The regulation of pepsin secretion by the sympathetic nervous system appears controversial: under normal conditions an inhibitory effect is prevailing, whereas under stress an increase in pepsin secretion is observed.
We studied the role of low plasma somatostatin (SRIF) levels in intestinal calcium absorption (CaA) in man. Plasma somatostatin-like immunoreactivity (SLI; pg X ml-1) rose after a 600-cal test meal (from 22.9 +/- 2 basally to 30.6 +/- 3.6 at 45 min, p less than 0.05), but was not affected by an oral Ca load (264 mg). Under intravenous SRIF (0.15 microgram kg-1 h-1) plasma SLI rose from 3.3 +/- 0.4 basally to 24.5 +/- 3 at 45 min (p less than 0.001). CaA was not influenced under these conditions, whereas insulin levels fell significantly and the levels of PTH, calcitonin, glucagon and GH were not changed. A regulating role of SRIF in CaA seems therefore unlikely for human physiology, since neither SLI is influenced by an oral Ca load, nor is CaA changed under postprandial SLI. The fall in insulin under postprandial-like SLI levels favors the view of a hormonal role of SRIF in man.
Surgical splanchnicectomy protects against stress ulcers in the presence of an intact adrenal medulla. The additional removal of adrenal medullary catecholamines results in an augmentation of gastric lesions. Inhibition of gastric acid secretion, improved gastric mucosal blood flow, enhanced gastric oxygen extraction, and increased energy supply to gastric tissue are discussed as possible protective mechanisms.
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We have searched for elevated basal plasma somatostatin in patients with documented cholelithiasis (n = 37) and compared the data with healthy control subjects (n = 27). Using an acidic assay system for measuring somatostatin in unprocessed plasma, we could not find deviations from normal values in biliary stone patients. Also basal blood levels of other islet cell hormones (insulin, glucagon) and minerals (calcium, magnesium) are unchanged. Further studies are needed to find out whether an abnormal response of plasma somatostatin to appropriate stimuli can play a role in the etiology of biliary stones.
Calcium and oxalate were studied in daily, fasting and postprandial urine specimens from healthy subjects and patients with idiopathic renal calcium stones in response to a test meal free of oxalate, and supplemented with calcium and 14carbon-oxalic acid. The data showed that the amount of oxalate in fasting urine of patients with stones did not differ from that in controls. Generally, patients with stones had considerable postprandial hyperoxaluria in terms of excretion and concentration, associated with a significantly higher degree of supersaturation with regard to calcium oxalate compared to controls. These findings were paralleled by decreased intestinal absorption of 14carbon-oxalate and by unchanged 24-hour urinary oxalate. Although the source of increased postprandial oxalate in patients with stones is not clear the possibility of enhanced de novo synthesis from oxalate precursors is discussed. In patients with different types of calciuria the 2 main risk factors (hyperoxaluria and hypercalciuria) for the process of stone formation are recognizable more readily in the postprandial urine specimens than in fasting or daily urine specimens.
Hanisch E, Schwille PO. Effects of various vagotomies and sympathectomies on gastric secretory function in the non-stressed and by immobilization stressed rat. Scand J Gastroenterol 1984, 19, Suppl 89, 99-104 The aim of the present study was to study several gastrointestinal parameters (acid, pepsin secretion, ulcer index, gastrin, somatostatin, glucagon) following various forms of sympathectomies in comparison with vagotomies under two different states of sympatho-adrenal activation in male gastric fistula rats. It is concluded that acid and pepsin appear regulated by the autonomous nervous system, even in the basal state. Gastric ulcer formation/prevention depends on gastric sympathetic innervation and on the state of activation of the adrenal medulla. Basal gastrin, somatostatin, glucagon may be modified by both limbs of the autonomous nervous system.
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The urinary excretion of calcium, oxalate, citrate and magnesium, and the relative saturation products in urine of either calcium oxalate or calcium phosphate, were determined in male duodenal ulcer (DU) patients preoperatively (n = 60), and 1 and 5 years following highly selective vagotomy (HSV), and in male healthy controls (n = 30). In DU before HSV citrate and magnesium were lowered, oxalate was in the low normal range and calcium was normal. The calcium oxalate product was lower than in controls, while the calcium phosphate product was unchanged. Within 5 years HSV normalized urinary citrate and oxalate, but not urinary magnesium, and the median urinary pH was lower than pre-operatively. There thus results a normal product for calcium oxalate, but a reduced one for calcium phosphate. It is suggested that: (1) unoperated DU patients have a urine composition similar to that exhibited in normocalciuric recurrent calcium urolithiasis; (2) this spectrum of urinary constituents may be changed by HSV.
In non-stressed rats and rats stressed by immobilization, gastric secretion (acid, pepsin), mucosal blood flow (MBF), stress ulcers as well as glucose, insulin, and glucagon in blood were studied during 8 h, with and without additional infusion of exogenous glucagon (0.2, 1.4, 9.8 micrograms/kg/h). Metabolic clearance of glucagon and the disappearance half-time of exogenous glucagon from blood do not differ during zero stress and stress, a fact that favors the assumption of hypersecretion of glucagon as the cause of stress hyperglucagonemia. During stress alone acid secretion (volume, acidity) and MBF are lower than during zero stress; pepsin remains unchanged. Under zero stress condition additionally administered glucagon inhibits pepsin and MBF, but not acid secretion, in a dose-dependent manner. The ulcer index increased without changing the severity of ulcers. During stress the intermediate and highest glucagon doses stimulate MBF and pepsin secretion, other variables remaining unchanged. It is concluded that glucagon effects on functions of the gastric mucosa in the rat vary fundamentally, depending upon the environmental conditions.
The influence of highly selective vagotomy (HSV) upon mineral metabolism was investigated in patients with duodenal ulcer (DU). Data obtained before HSV were compared with those from healthy control subjects and, additionally, with data from pre- and post-HSV observations. In DU the function of the parathyroid glands is unsettled because of decreased renal phosphate threshold, normal serum parathyroid hormone and decreased nephrogenous urinary cAMP. HSV decreases the phosphate threshold further, but does not change parathyroid hormone, calcitonin, or nephrogenous cAMP. Conversely, besides hypergastrinemia, HSV accounts for a decrease in total calcium in serum in the presence of an increase of the intestinal calcium absorption, while the bone mineral content is stable up to 5 years following HSV. Moreover, HSV normalizes the decreased serum concentration of 25-hydroxyvitamin D found pre-operatively in DU, while that of 24,25-dihydroxyvitamin D, known to be effective upon bone and gut, remains unaltered. A classification according to pre-operative gastric acid secretion (normo- and hypersecretors) does not provide further insights into variables of mineral metabolism encountered in DU pre- and post-HSV.
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