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Biomedical subjects

E Ogris

Publications and source records attributed to E Ogris.

At least 73 records · Page 4Linked to original sources
PubMed1981

[Alanine as a nitrogen sparing and gluconeogenetic substrate in the postoperative state (author's transl)].

UNLABELLED: An alanine infusion (90 mg/kg/h) for eight hours was administered to seven patients after cholecystectomy in order to investigate the influence of elevated plasma alanine levels on the postoperative metabolism. The following metabolites and hormone concentrations were analysed in plasma: glucose, urea, free fatty acids, ketone bodies, amino acids, insulin and glucagon. Compared to the pre-infusion values on the 1. postoperative day after an overnight fasting, the following changes were monitored. The plasma glucose concentrations reached a maximum after four hours of infusion (p less than 0.05). Of the amino acids, significant elevated levels were found for alanine (300%, p less than 0.001), glutamine (36%, p less than 0.05), and alpha-aminobutyrate (61%, p less than 0.01). The free fatty acids and ketone bodies concentrations decreased immediately after the onset of the infusion of alanine (p less than 0.05), the increased again during the last four hours of infusion. The secretion of insulin and also the secretion of glucagon were stimulated by the increased alanine levels. The stimulation of insulin reached a maximum after only five minutes, but the glucagon levels increased continuously until the end of the infusion. During the administration of alanine a nitrogen homeostasis was achieved, which was a significant improvement (p less than 0.001) when compared to saline infusions before and after the alanine infusion. CONCLUSIONS: (1) Postoperative increased plasma levels of alanine stimulate gluconeogenesis and reduce the plasma levels of lipolytic metabolites. The induced stimulation of insulin and glucagon is dependent on the duration of the alanine infusion for during extended infusion of alanine the insulin stimulation diminishes while the glucagon secretion continuously increases. (2) Alanine is a potent anabolic substrate in the immediate postoperative situation.

Alanine↗
PubMed1981

Noninvasive rCBF determination by 133XE-inhalation with the gamma camera and functional imaging of wash-in and wash-out. A new combined approach for rCBE measurements in patients with cerebrovascular disease.

In 47 patients with cerebrovascular disease (CVD) a noninvasive determination of global and regional cerebral blood flow (CBF) was performed with the gamma camera. A new approach was developed for region definition and for evaluation of the "start-fit-time' as the point of minimal contamination of the recorded data by extracerebral scatter and recirculation using the region of interest (ROI)-technique in the camera field of view. In comparison with the results of probe measurement of end-tidal exhalation air no significant differences were seen and values obtained were well in the range reported by other authors. Initial slope (IS), gray matter flow (F1) and CBF-15 were used as quantitative parameters and were able to distinguish significantly (P less than 0.01) between normals, patients with mild CVD, and severe CVD. Intraexamination variation coefficient (VC) was 5%, interexamination VC was 8%. Functional, parametric images of wash-in for easier ROI-definition and judgement of isotope supply and of wash-out were generated by a computer analysis and were found to be sensitive indicators for arterial blood supply and wash-out values city. Thus it was possible to recalculate regional flow values in focal areas exactly corresponding to abnormalities seen on the functional images. So the regional information of functional images can be combined with the quantitative data in selectable areas. By tis noninvasive, easily performed method focal neurological deficits can be evaluated with high accuracy with conventional nucleus medicine equipment.

Cerebrovascular Circulation↗
PubMed1981

[Diabetes and Pregnancy (author's transl)].

UNLABELLED: The article reports on the experiences collected during treatment and delivery of 316 pregnant diabetic women hospitalized in the municipal hospital of Vienna-Lainz. 1. Close co-operation between diabetologist, obstetricians and pediatricians in imperative. 2. Early diagnosis and recording - as far as possible before conception -, accurate control and intensive care by the diabetologist and obstetrician right from the beginning is most essential; the aim should be to attain normoglycaemic levels preferably during the first 3 months of pregnancy. 3. In the case of diabetic patients requiring insulin who are difficult to stabilize, it would be desirable to effect stabilization in the hospital, followed by self-control of blood sugar levels with self-adjusted insulin variation. Above all, overweight should be avoided. 4. Obstetric intensive care can be effected only in a department with modern equipment. 5. In case of complications, it will always be necessary to provide for additional hospitalization over and above the routine cases; such hospitalization must always consist of combined obstetric and internistic medical care. 6. Prognostically Bad Signs of Pregnancy (PBSP) groups must be kept as small as possible. 7. Childbirth should be approximated as closely as possible to the calculated date of birth (in While A cases up to the 40th week of pregnancy, with the other patients at least up to the 38th week of pregnancy). The necessary controls which can justify postponing the time of birth, are explained. The approximation to the calculated data of birth depends largely on optimal stabilization of the diabetes to normoglycaemic levels during the entire pregnancy period. This is documented, inter alia, by normal weight of the newborn at the time of birth, corresponding to the duration of pregnancy. 8. Vaginal delivery should be aimed at. 9. Newborn are always high-risk infants; the first few minutes of live are absolutely decisive. The infants should be placed in the care of a team of pediatricians as early as possible, combined with transfer to a children's hospital with intensive-care ward, using an intensive-care ambulance for effecting the transfer. 10. RESULTS: These measures led to a reduction of the mortality rate (reduced to the corrected values), the average of which had been 12.5% during 1970-1971, to 1.85% during 1972-1979. The proportion of PBSP groups, which was originally 32.42%, dropped during the same period to 20.79%, the perinatal mortality in this group being reduced from 50% to 17.24%.

Blood Glucose↗
PubMed1980

[Changes in glucose, fat and hormone balance induced by the postoperative administration of alanine solution].

Seven patients undergoing cholcystektomy received a 5 pevcent solution of alanine (90 mg/kg/h) during a period of 8 hours on the 1. postoperative day. Stimulation of gluconeogenesis was observed with increase of glucose from 5,9 +/- 0,2 to 6,3 +/- 0,2 mmol/l. Initially the level of ketone bodies decreased (acetoacetate 70 +/- 23 to 17 +/- 6 mumol/l) but again increased to start values during infusion of alanine. Insulin increased twofold from 7,6 +/- 1,4 microU/ml to 14,6 +/- 4,0, and had a constant level during infusion as did glucagon, which increased from 561 +/- 70 to 608 +/- 74 pg/ml. Nitrogen balance during infusionsperiod was almost zero (0,04 +/- 0,09 g/h minus) showing a significant difference to balances calculated from periods before and after infusion of alanine (0,57 +/- 0,07 and 0,53 +/- 0,06 g/h deficit respectively). Direct influence on peripheral glucose alanine cycle and increased gluconeogenetic substrate seem to be responsible for the nitrogen sparing effect of alanine.

Alanine↗
PubMed1979

[Comparison of glibenclamide, gliquidone, glisoxepide and placebo in maturity onset diabetics of differing degrees of severity (author's transl)].

The purpose of the study was to investigate whether the potency of effect on the beta cell differs with type of sulfonylurea (SU) and with degree of severity of diabetes. 12 maturity onset diabetics were classed according to fasting blood glucose (FBG) in three groups of 4 patients each. Each patient served as his own control. Glibenclamide, Gliquidone, Glusoxepide and placebo were administered in random order with degree dosage adjusted according to degree of severity of diabetes. All patients were given a standardized diet with 150 g carbohydrates per day. Fullday profiles of blood glucose, insulin, C-peptide and sulfonylurea level in serum were made on the third day under each preparation. Results showed that with proper nutrition and sufficient weight reduction, patients in group I (FBG 80--130 mg/dl) needed no oral medication and in fact showed a tendency towards hypoglycaemic episodes under oral therapy. In group II (FBG 130--200 mg/dl) the effect of nutrients on beta cell secretion appeared to be both enhanced and accelerated by SU administration. Satisfactory metabolic control was achieved with SU, but not with placebo. This group seems to represent the type of patient most likely to benefit from SU therapy. In spite of high dosage levels, satisfactory control was not achieved with SU in any patient in group III (FBG greater than 200 mg/dl). Depending on individual factors such as ketosis-proneness, vascular complications, age and psycho-social aspects, insulin administration should be considered for these patients. There were not differences between the individual SU preparations in the parameters studied. There was insufficient evidence for a pharmacokinetic differential diagnosis.

Blood Glucose↗
PubMed1979

[The value of different investigation procedures in arterial hypertension (author's transl)].

221 patients with arterial hypertension were investigated as outpatients. 198 patients were found to have primary and 23 patients to have secondary hypertension. The results of urinary analysis were pathological in 25% of patients and renal function tests were abnormal in 20% of cases. Significant bacteriuria was recorded in 19% of urinary cultures. Intravenous pyelography showed true pathological findings in 12% of cases, false positive findings in 7% and false negative findings in 5%. Isotopic nephrograms showed true positive findings in 52%, false negative in 3% and 45% showed normal results. In 53% of patients angiography of the kidneys showed normal results, whilst this investigation proved pathological in 44% of cases and gave false negative results in 3% of patients. An additional search for coronary heart disease risk factors revealed that 73% of these hypertensive patients were overweight, 47% had hyperlipidaemia, 33% suffered from diabetes mellitus and nicotine abuse was present in 21% of cases. A relevant yet inexpensive screening programme for the investigation of hypertension is formulated on the basis of the results of this investigation.

Adult↗
PubMed1979

[Carbohydrate metabolism investigations in children of diabetic mothers (author's transl)].

A follow-up examination was conducted in 65 children aged up to 7 years whose mothers manifested diabetes mellitus during pregnancy and who had to be transferred to the Children's Hospital at Glanzing, Vienna for post partum complications. No case of manifest diabetes mellitus was recorded. Carbohydrate metabolism was investigated by determining immunological insulin (IRI) and the insulinogenic index during an oral glucose tolerance (OGTT). Three children showed pathological findings; two of them showed incomplete or delayed insulin secretion during the OGTT. One child displayed an inadequate rise in the insulinogenic index with high individual insulin values during the OGTT, which gave border line results. We support the point of view that children of diabetic mothers should be controlled with regard to carbohydrate metabolism regularly to recognize premanifest diabetic states at an early stage.

Carbohydrate Metabolism↗
PubMed1979

Radionuclide assessment of cardiac performance and myocardial perfusion in congestive cardiomyopathies.

To determine the reliability of radionuclide techniques in the diagnosis of congestive cardiomyopathy (COCM), the function of the right ventricle (RV) and left ventricle (LV) was evaluated in 32 patients with COCM and 21 normal subjects using radionuclide angiography (first pass and gated blood pool scan) combined with quantitative 201 thallium (Tl) myocardial perfusion imaging. In COCM parameters of RV and LV performance were significantly reduced (p less than 0.01); regional wall motion analysis revealed a reduced radial shortening ability (p less than 0.05). 201 Tl distribution within the myocardium was not different between COCM and N; however, segmental 201Tl-uptake was significantly reduced (p less than 0.01). RV free wall was visualized on 201Tl scan in 80% of patients with COCM. There was no correlation between RV free wall visualization and RV hemodynamics. Thus these scintigraphic aspects provide an atraumatic and sensitive technique for the evaluation of patients with COCM.

Adult↗
PubMed1979

Assessment of left ventricular performance and myocardial viability using quantitative radioisotope techniques.

The diagnostic value of a combined radionuclide technique was compared with conventional angiocardiographic techniques in 60 patients with coronary artery disease. Quantitative 201Tl myocardial imaging combined with radionuclide angiocardiography using 99mTc-HSA provided a safe and accurate method for the assessment of left ventricular performance. The defects on the 201Tl images correlated with the severity of asynergy seen on the contrast ventriculogram. Static imaging alone distinguished hypokinetic from akinetic or dyskinetic areas. However, using both tracer techniques, akinesis could bedistinguished from dyskinesis. In patients with disturbed left ventricular function, cardiac transit times correlated with haemodynamic changes, and left ventricular ejection fraction was the most sensitive index. Thus, this combined radionuclide approach provides data for the evaluation of overall and regional wall function. A major advantage of this non-invasive auantitative technique is its applicability to the critically ill patient at the bedside.

Adult↗
PubMed1979

[Scintigraphy in cardiomyopathy].

The function of the right ventricle (RV) and left ventricle (LV) was evaluated in 32 patients with congestive cardiomyopathies (COCM), 10 patients with hypertrophic cardiomyopathy (HOCM) and 21 normal subjects (N). In all these patients myocardial perfusion was analysed using quantitative 201 Tl myocardial perfusion imaging. In COCM parameters of RV and LV performance were significantly reduced (p less than 0.01); regional wall motion analysis revealed a reduced radial shortening ability. Regional Tl-distribution was not different in COCM and N; however, relative Tl-uptake was significantly reduced (p less than 0.05). 80% of all patients with COCM showed the RV free wall on Tl-perfusion scintigrams. These scintigraphic aspects allow a noninvasive differentiation of a disturbed LV function and the classification of coronary and primary myocardial etiology. In patients with COCM the scintigraphically determined thickness of septum and free wall of LV was increased as compared to N (p less than 0.05). The ratio septum/lateral wall of LV averaged 1.3 +/- 0.20. Quantitative analysis of regional Tl-uptake revealed increased segmental relative Tl-uptake. In the majority of patients there was a disproportionate septal hypertrophy on the gated blood pool scan in LAO. These radionuclide techniques allow a dynamic two-dimensional evaluation of the interventricular septum and the LV.

Cardiomegaly↗
PubMed1978

Assessment of regional wall motion in coronary artery disease using radionuclide methods.

72 patients with CAD, 10 patients with congestive cardiomyopathies and 10 normal subjects were evaluated by radionuclide angiography. Comparison with contrast angiography showed good results for LVEF (r = 0.83). Regional asynergies observed in the radionuclide angiography correlated well with defects in thallium scintigrams. Extent of abnormal wall motion was measured and compared with normals, appreciating the deviation from the normal mean radial shortening. Good correlation could be demonstrated with radionuclide ventriculography. In 80% of congestive cardiomyopathies the right ventricle wall became visible in the thallium scintigram.

Cardiomyopathies↗
PubMed1977

[Suppressive effect of somatostatin on secretin-CCK-PZ-stimulated endocrine and exocrine pancreatic function in man (author's transl)].

With a view toward the therapeutic use of somatostatin in the treatment of acute pancreatitis, a preliminary investigation was conducted with 6 healthy volunteers, in which the suppressive effect of somatostatin on endocrine and exocrine pancreatic function was observed. A 30-minute baseline measurement period was followed by the administration of cyclic somatostatin (100 microgram by i.v. injection plus a 90-minute infusion at a rate of 200 microgram/hr). After the first 45 minutes of this infusion secretion was submaximally stimulated by the infusion of secretin-cholecystokinin-pancreozymin (CCK-PZ) (75 U each), over two hours. No decrease was observed in basal bicarbonate or enzyme concentration under somatostatin administration alone. However, secretion did not show the usual steep rise after the commencement of stimulation. After the somatostatin infusion was stopped, i.e. under secretin-CCK-PZ alone, a significant increase occurred in the values of secretin-induced volume, bicarbonate concentration and total bicarbonate contents of the duodenal aspirate, as well as in CCK-PZ-induced enzyme secretion. The release of insulin, both basal and stimulated, was also significantly decreased by somatostatin.

Adult↗
PubMed1977

[Diabetes and pregnancy: treatment and results (author's transl)].

Pregnancy and delivery in 190 diabetic women are described. Obstetric, medical and neonatal guidelines for treatment are outlined and the following results are reported: 1. The delivery dates suggested by P. White were generally exceeded by 2 weeks. Group A was delivered at term, group B generally in the 38th week, group C between the 37th and 38th week and group D mostly in the 37th week of gestation. 2. Spontaneous delivery was achieved in 60% of the cases; Caesarean section was necessary in 33%, whilst the incidence of vacuum extraction was 5%. 3. The perinatal infant mortality rate in diabetic pregnancy decreased from 22.9% in 1970/71 to 2.7% in 1972/1976. 4. Perinatal mortality was related to the degree of severity of diabetes according to White's classification. 5. The percentage of PBSP cases was lowered from 32% to 24%. Perinatal mortality in the PBSP group decreased from 50% in 1970/71 to 19% in 1972/1976. 6. Hypoglycaemia occurred in 70% of 74 newborn infants submitted to intensive neonatal care. A true glucose value of less than 25 mg% was recorded in 30% of these cases. Hypocalcaemia was present in 16% cases, whilst 62% of the newborn infants suffered from respiratory distress syndrome. Cardiomegaly occurred in 28% of infants. 7. Development and prognosis are judged to be favourable in children of diabetic mothers.

Austria↗
PubMed1977

[Human placental lactogen and chorionic gonadotropin in diabetic pregnancies (author's transl)].

Serial determinations of serum HPL and HCG levels were carried out in 68 diabetic women during the whole course of pregnancy. In diabetic pregnancies of the type B--D according to White's classification, HPL levels were significantly lower than control values from the 10th to the 22nd week. In diabetic pregnancies of the type White A, HPL levels were significantly lower than the normal controls at the 10th and the 38th week, otherwise there was no significant difference between the two groups. A decrease in HPL level occurred in the 37th week in normal pregnancies and in the 34th week in diabetics. Integrated values of HPL over each trimester of pregnancy (which give a measure of the overall hormone production), were all significantly lower in the diabetic pregnancies than in the normal controls. Peak levels of HCG were found from the 8th to 12th week in normal pregnancy; subsequently a continuous fall was observed until the end of pregnancy. HCG levels were significantly higher in diabetic than normal pregnancies following the 30th week and generally rose to the end of pregnancy. The integral HCG values, in diabetics of all White groups, were significantly lower in the first trimester and significantly higher in the third trimester than in the normal controls. There was no difference in integral hormone production between diabetics and controls in the second trimester. A sudden drop in the level of both hormones is a signal of fetal distress.

Chorionic Gonadotropin↗