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Biomedical subjects

F Halter

Publications and source records attributed to F Halter.

At least 163 records · Page 9Linked to original sources
PubMed1978

A comparison between intragastric titration and aspiration technique under basal conditions and after food or pentagastrin stimulation.

A total of 16 healthy subjects had gastric secretory studies where acid was either measured by the conventional aspiration technique (AT) or by intragastric titration at a pH of 5.0 (IT). In a first study food- and pentagastrin-stimulated PAO levels, both measured by IT, were within similar ranges. However, as compared to the respective AT data of the same subjects, the mean IT results were 35% higher, although both values were well correlated. In a second study a similar difference was observed between IT and AT data throughout the whole range of the pentagastrin dose-response curve. Both curves followed Michaelis-Menten kinetics and had similar Km values, while Vmax values were significantly higher at IT. This constellation excludes an increase of the gastrin sensitivity of the parietal cells as a cause for the higher IT data. It is, however, in keeping with the hypothesis that the distension stimulus present at IT potentiates the pentagastrin-stimulated acid secretion. It is likely that methodological problems such as overtitration of acid at IT and transpyloric loss of acid at AT additively contribute to the relatively large difference between AT and IT values. It is therefore not possible to fully interchange AT and IT data, despite their good correlation.

Adult↗
PubMed1978

The endogenous release of pancreatic polypeptide by acid and meal in dogs. Effect of somatostatin.

The response of pancreatic polypeptide (PP) to testmeal (5 ml/kg) and intraduodenal acid (4 mEq HCl/5min) and its reaction to somatostatin (3.5 microgram/kg/h following bolus injection of 3.5 microgram/kg) was studied in dogs with chronic duodenal and gastric fistulae. In addition the influence of atropin (0.5 mg/kg/h) on acid-induced PP response was examined. PP was measured by radioimmunoassay pancreatic secretion by determinating volume, bicarbonate, protein, and enzyme in duodenal contents and pancreatic juice. Plasma PP increased significantly following intraduodenal application of testmeal and hydrochloric acid. Its release was completely suppressed by SST. Furthermore, PP response to intraduodenal acid was blocked by atropin. Exocrine pancreatic secretion of bicarbonate and protein was inhibited by somatostatin as well as atropin. Since PP was released following administration of testmeal and acid, both potent stimulators of pancreatotropic duodenal hormones, it may play an important role in the control of the entero-pancreatic axis. The effect of atropin indicates a cholinergic nervous component of PP release.

Amylases↗
PubMed1977

Intragastric titration of acid in the perfused rat stomach preparation following parenteral and intraluminal stimulation.

The anaesthetised rat stomach preparation was adapted to assay intraluminally administered stimulants and inhibitors of acid secretion by continuously recirculating the perfusate (15 ml of 5% glucose) and measuring acid by the pH-stat technique. The responses obtained were linear. Continuous artificial neutralisation of the stomach to pH 5.5 as well as variation of the pH between 6.5 and 4.0 did not significantly alter the sensitivity of the preparation to intravenously administered human gastrin-heptadecapeptide I (HG I). Basal acid secretion however significantly declined following stepwise lowering of the intragastric pH between 6.5 and 4.0. The threshold values for responses to i.v. HG I were below 16 ng. 6 doses could be given per rat without tachyphylaxis. Acetylcholine, 1.3, 2.5, 5.2 and 10.4 micron g/ml in the perfusate, induced a dose-dependent linear (r=0.902) acid secretion. Metiamide 1.66 mg/ml in the perfusate, produced a parallel shift to the right of the HG I dose--response curve producing an agonist dose ratio of 3.66. The data suggest that intragastrically applied stimulants and inhibitors of acid secretion can be studied precisely in this relatively simple preparation.

Acetylcholine↗
PubMed1977

Diagnostic value of biopsy, guided lavage, and brush cytology in esophagogastroscopy.

In a prospective study 96 patients with esophageal and gastric lesions were investigated by multiple endoscopic biopsy, brush cytology, and guided lavage cytology. The aim was to evaluate the diagnostic accuracy of each of these methods in a prospective study. 50 malignant and 46 benign lesions were found. The final diagnosis was proven by operation or autopsy in 53 cases, by multiple endoscopic follow-up in 31, and by clinical control in 8. No follow-up was possible in 4 patients. The malignant lesions were diagnosed by multilple biopsy in 86.0%, by brush cytology in 84.0%, and by lavage cytology in 50.0%. The diagnostic yield of lavage cytology was thus significantly lower (P less than 0.01). It is concluded that a combination of multiple biopsy and brush cytology is the most valuable aid in endoscopic diagnisis of esophageal and gastric malignancy with a diagnostic accuracy of 96%.

Adolescent↗
PubMed1977

Gastric and duodenal ulcer healing under placebo treatment.

The healing time relation of 30 gastric and 15 duodenal ulcers was assessed by repeated endoscopic measurements of ulcer size on days 1, 21, and 42 of a 6-week period, during which a selected population of patients was being treated as outpatients on an inert placebo. Antacids in small amounts were only given in case of ulcer pain. There was evidence for a linear relationship between the absolute initial ulcer size and its reduction with the time in incompletely healed ulcers of both types. Their percentage reduction from the original size was 71% after 3 weeks in gastric and 83% in duodenal ulcers; 82% after 6 weeks in gastric and 83% in duodenal ulcers. The healing time course for both types of ulcers appeared to follow an exponential function. The calculated half-life was 1.7 weeks for gastric and 1.9 weeks for duodenal ulcers. The number of healed duodenal ulcers observed at the 3-week examination was significantly greater than that of healed gastric ulcers (P = 0.05). It is concluded that repeated measurements of the ulcer size before complete ulcer healing contribute to a optimal characterization of the healing time course. The calculated half-life of less than 2 weeks makes shorter control intervals reasonable for both types of ulcers. The ulcer half-life appears to be a more accurate criterion of the healing process than that of complete healing.

Adolescent↗
PubMed1976

The development of a reliable and sensitive bioassay for gastrin in body fluids.

The sensitivity and reliability of the Ghosh and Schild rat stomach preparation was improved by implantation of bulky intragastric cannulae, recirculation of the perfusate and measurement of conductivity instead of pH. With these procedures, the threshold values for gastrin I were in the range of 1-2 ng. In attempts to increase the sensitivity further it was shown that neither vagotomy nor antrectomy influenced the sensitivity of the method. The threshold values were not lowered by attempts to reduce gastrin metabolism through nephroligature or small bowel resection. Although rats fitted with portacaval shunts did raise the threshold, the limited increase in sensitivity was also achieved by selecting the rats that gave an initially high response to a test dose of gastrin thus avoiding the complicated shunt operation. The assay procedure enabled statistically valid measurements of gastrin in plasma and from tumour extracts from patients suffering from the Zollinger-Ellison Syndrome to be assayed using a 2 + 2 block design.

Analysis of Variance↗
PubMed1976

Evaluation of specific value of endoscopic biopsies and brush cytology for malignancies of the oesophagus and stomach.

The value of multiple biopsies and brush cytology at oesophago-gastroscopy was assessed in relation to macroscopy and localization on 100 verified tumours in a prospective study. The cumulative accuracy achieved was 96%. This was significantly better (P less than 0-01) than that of biopsy (83%) and of cytology (85%). While the reliability of both procedures was not significantly different in malignancies of the oesophagus, the gastric body, and the antrum, cytoloty was significantly more accurate in cancers of the cardia (90% and 55% respectively, P less than 0-05). Cytology was also more reliable in stenosing tumours (92%/72%,P less than 0-05). In polypoid malignancies a positive but not significant trend was found in favour of multiple biopsies (94%/64%). One of the two early cancers was only diagnosed by cytology. The results confirm the high diagnostic accuracy of multiple endoscopic biopsies combined with brush cytology and demonstrate the value of cytology in stenosing tumours, especially in those of the cardia.

Adult↗
PubMed1976

Lower esophageal sphincter in reflux esophagitis.

Lower esophageal sphincter pressure (LESP) was studied by intraluminal perfusion-manometry in the resting state and after graded intravenous doses of pentagastrin in 12 healthy subjects and 27 patients with reflux esophagitis. These patients were classified as having ulcerative (11) or non-ulcerative esophagitis (16) by histological examination and endoscopic appearance of the inflamed mucosa. The length of the LES was similar in patients and controls. A correlation was found between the magnitude of mean basal end-expiratory (mbe) LESP reduction and the grade of esophageal mucosa inflammation. The most reduced mbe LESP value was shown in patients with ulcerative esophagitis. It was significantly different from that of patients with non-ulcerative esophagitis (t = 3.37, p less than 0.01). Both values were significantly reduced from that of the controls (t larger than or equal to 0.0125). The responsiveness of the LES to intravenous pentagastrin was quantitatively reduced throughout the whole range of the dose-response curve in patients with ulcerative esophagitis, whereas patients with non-ulcerative esophagitis only differed in the maximum mbe pressure value from the controls. Four patients showed a paradoxical pressure decrease to intravenous pentagastrin, resulting in a LESP reduction to 8% of the mbe LESP. Intravenous secretin or CCK led to a similar reaction of the LES in these patients.

Adult↗
PubMed1975

[Clinical problems of amebiasis].

Dagnostic and therapeutic problems of amebiaiss, a disease rarely observed in this country, are discussed in the light of four own cases representing the various courses of the disease. These observations prompt the following conclusions: 1. Amebiasis should be considered in cases of unclear acute or chronic intestinal disease, even if the patient has never visited endemic regions. 2. Non-tropical forms of amebiasis may follow a severe course with complications such as liver abscess or ameboma. 3. The advice of a specialized laboratory is necessary for stool examinations on amebae. 4. Stool examinations for amebiasis should be combined with serological tests. The immunofluorescense test is of special value. False negative results are however possible, especially in cases without tissue inflitration where the infection is limited to the intestinal lumen. 5. Metronidazol (Flagyl) greatly simplifies the treatment of amebiasis as it is both efffective and better tolerated than most other antiamebic agents.

Adult↗
PubMed1975

[Pre and postoperative secretion studies in selective proximal vagotomy. Report on 50 patients].

In 50 patients with peptic ulcer (48 duodenal ulcers and 2 pyloric channel ulcers) proximal gastric vagotomy was performed. The diagnosis was confirmed by radiology and endoscopy in all cases. Pentagastrin-stimulated maximal acid output (MAO) was measured preoperatively. At 6-12 months after the operation a pentagastrin test (6 mug/kg) and an insulin test (12 units regular insulin intravenously) were carried out. The results of the insulin tests were assessed by 5 criteria. In patients with 3 or more positive criteria the vagotomy was considered incomplete. 30 patients had "complete" and 20 "incomplete" vagotomy. MAO was reduced by 56%. The mean reduction of MAO was 63% in cases of "complete" vagotomy and 46.5% in "incomplete" vagotomy. The purpose and indication of postoperative studies of gastric secretion are discussed.

Duodenal Ulcer↗