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Biomedical subjects

F Schulz

Publications and source records attributed to F Schulz.

At least 91 records · Page 5Linked to original sources
PubMed1984

A new method for long-term intravenous alimentation in unrestrained rats.

A new technique for continuous long term intravenous alimentation in unrestrained rats has been developed. The model involves the use of the intravenous tubing set which was constructed from the barrel of a 1 ml syringe-cylinder with flanges sutured to the rat's skin. After inserting the silicone catheter into the jugular vein the free end was exited at the intraauricular area and passed through the intravenous tubing set. The tubing was then connected with a silk suture to the top of the cage. This prohibits twisting of the system and allows unrestrained movement of the rat in the cage with a rotation of 6-8 turns in either direction. The metabolic cage was constructed from an inverted 4-liter glass jug with the base removed. A floor and root were fashioned from coarse wire screen. Urine and feces were easily separated and collected through the neck of the jug. This new "proxy" set was tested and compared with the standard swivel assembly parameters in rats infused by either method. However, the cost of the new set (excluding pump) was almost 90 times less than its commercially available counterpart. This self constructed approach should bring small animal research within the economic means of the most investigators.

Animals↗
PubMed1984

Proteinases and inhibitors in plasma and peritoneal exudate in acute pancreatitis.

Examination of the peritoneal exudates of 12 patients with acute pancreatitis revealed high activities of pancreatic lipase and amylase. The immunologic levels of the plasma-derived inhibitors alpha 1-antitrypsin, antithrombin III and alpha 2-macroglobulin in the peritoneal exudates were not markedly different from those of the plasma. However, the inhibitory capacity of alpha 2-macroglobulin, the main inhibitor of human pancreatic trypsin in the exudate, was almost completely depleted when measured by an enzymatic method. Furthermore, spontaneous fibrinolysis occurred in 6 out of 13 exudates applied to plasminogen-free fibrin plates, indicating the presence of free proteinase. This fibrinolytic activity might be inhibited by exogenous alpha 2-macroglobulin or aprotinin (Trasylol, Bayer AG).

Acute Disease↗
PubMed1984

[Tumors of the endocrine pancreas].

37 patients suffering from apudomas of the pancreas are reported (18 insulinomas, 6 isletcell-hyperplasias, 9 Zollinger-Ellison syndroms, 1 glucagonoma, 3 without hormone production). In preoperative localization computerized tomography and angiography were the best with 65% positive findings. Insulinomas were enucleated, all free of recidives. 50% of operated isletcell hyperplasias had a postoperative resisting hyperinsulinism. Either gastrectomy or tumour enucleation was performed in the Zollinger-Ellison syndrome. The five-years survival rate was 43%.

Adenoma, Islet Cell↗
PubMed1984

[Clinical aspects and therapy of congenital cystic livers].

Thirty patients with congenital cystic disease of the liver are reported. Expansion with pain, jaundice, cholangitis and suspicion of malignancy are indications for surgical intervention. Operation is chosen according to localization, size, quantity of cysts and their fluid content. Resection, fenestration, punction, anastomosis and hemihepatectomy were performed. Postoperative mortality was about 3%, prognosis is well, but worsened by associated diseases like polycystic kidneys or intramural aneurysms.

Cysts↗
PubMed1984

[Duodenal hematoma in acute alcoholic hepatitis].

Hematoma of the duodenal wall usually occurs after traumata. A case report is given of such a patient who suffered in addition from acute alcoholic hepatitis. The hematoma had led to complete obstruction of the duodenum and compression of the common bile duct. After endoscopy surgery was done and the hematoma removed.

Abdominal Injuries↗
PubMed1983

Studies on cortisol substitution therapy in patients with adrenal insufficiency.

To eight patients with Addison's disease 25 mg of cortisone acetate or cortisol, respectively, was given orally. Thereafter blood samples were taken and analysed for total cortisol, "free" (not protein bound) cortisol and ACTH. Furthermore, urine cortisol excretion and the cortisol binding capacity of the plasma were determined. We found that after the substitution therapy the increase of the plasma cortisol was variable and reached its maximum after 45 to 240 minutes. However, if the resorption time was subtracted the individual differences were less pronounced and plasma cortisol levels above 8 micrograms/dl could be maintained for about six hours. When cortisol was taken instead of cortisone acetate the increase of the plasma cortisol was steeper, decreasing then more rapidly. Plasma "free" cortisol ranged from 2.75 to 6.19% in relation to total cortisol and closely paralleled the level of total cortisol in each patient during the course of the experiment. The excretion of unconjugated cortisol in urine amounted to 56.5 +/- 26 micrograms (SE) and was better correlated to the concentration of "free" cortisol than to total plasma cortisol. The behaviour of plasma ACTH levels was variable. Great fluctuations with high morning levels and good suppression was observed in patients having their substitution tablet only in one single morning dose. From these biochemical data recommendations for the substitution therapy in patients with adrenal insufficiency were given.

Addison Disease↗
PubMed1983

Ultrastructural aspects of striated muscle fibers in health and disease.

The application of electron microscopy to skeletal muscle is pertinent to 1. cytological analysis of normal muscle fibers; 2. cytopathology of muscle fibers; 3. systematic ultrastructural analysis of classic muscle diseases; 4. ultrastructure of muscle fiber inclusions; 5. neuromuscular conditions classified by electron microscopy; 6. diagnosis of individual muscle biopsies.

Humans↗
PubMed1983

[Lack of stimulation of nitrogen retention and plasma protein synthesis due to increased intake of branched-chain amino acids].

In a randomised study the influence of 3 different amino acids (AA) solutions on nitrogen balance, plasma protein synthesis, and plasma and urine AA pattern was investigated in postoperative (p.o.) cancer patients. The patients in group I received a balanced AA solution designed especially for p.o. patients with 10 percent branched chain amino acids (BCAA), those in group II a solution with 60 percent BCAA and those in group III a solution with 67 percent alanine. All patients received the same amount of nitrogen (0.16 g/kg BW/day) and energy (2.p.o. day: 80 kJ/kg BW/day; 3.-5. p.o. day: 160 kJ/kg BW/day) with a 3:1 ratio of carbohydrate to fat calories. No difference was observed between the three groups for mean daily nitrogen balances, however, the cumulative nitrogen balance of group I (-4.5 +/- 3.6 g) was significantly (p less than 0.05) improved compared to group II (-12.2 +/- 4.2 g). The p.o. decreased concentrations of short-life plasma proteins (prealbumin, transferrin, retinol-binding protein) increased until the end of the study period without any statistic differences between the three groups. On the 2nd p.o. day especially the gluconeogenetic AA were decreased in all patients, but were nearly normal in all patients on the 5th p.o. day. In conclusion the increased administration of BCAA neither improved nitrogen retention nor plasma protein synthesis and does not seem advantageous in the postoperative total parenteral nutrition.

Aged↗
PubMed1982

[ACTH in the dexamethasone suppression test].

Despite the great clinical importance of the low-dose dexamethasone suppression test (determination of cortisol after dexamethasone 2 mg p.o. at 11.00 p.m. in the evening before) and of the determination of ACTH in plasma, so far only little is known about the ACTH response to dexamethasone in normal subjects. In the present study cortisol and ACTH were determined by radioimmunoassay in normal subjects at 8.00 a.m., 10.00 a.m. and noon before and after dexamethasone. Additionally the cortisol response to ACTH was tested under both conditions. The ACTH concentrations in the morning show a periodicity quite similar to the well-known circadian rhythm of cortisol secretion. Dexamethasone blocks this periodicity without decreasing ACTH significantly. The cortisol response to ACTH after dexamethasone is normal. In the morning only a basal and presumably biologically inactive ACTH is secreted which can not further be suppressed by dexamethasone. Therefore it is advisable for the diagnosis of hypercortisolism to measure ACTH only in stimulation tests, e.g. insulin-induced hypoglycemia.

Adrenocorticotropic Hormone↗
PubMed1982

[ACTH response in the dexamethasone suppression test].

Despite the great clinical importance of the low-dose dexamethasone suppression test (determination of cortisol after dexamethasone 2 mg p.o. at 11.00 p.m. in the evening before) and of the determination of ACTH in plasma, so far only little is known about the ACTH response to dexamethasone in normal subjects. In the present study cortisol and ACTH were determined by radioimmunoassay in normal subjects at 8.00 a.m., 10.00 a.m. and noon before and after dexamethasone. Additionally the cortisol response to ACTH was tested under both conditions. The ACTH concentrations in the morning show a periodicity quite similar to the well-known circadian rhythm of cortisol secretion. Dexamethasone blocks this periodicity without decreasing ACTH significantly. The cortisol response to ACTH after dexamethasone is normal. In the morning only a basal and presumably biologically inactive ACTH is secreted which can not further be suppressed by dexamethasone. Therefore it is advisable for the diagnosis of hypercortisolism to measure ACTH only in stimulation tests, e.g. insulin-induced hypoglycemia.

Adrenocorticotropic Hormone↗
PubMed1982

[Malnutrition and postoperative complication rate in cancer patients (author's transl)].

The nutritional status and skin reactivity of 82 cancer patients were determined before surgery and compared with the postoperative complication rate. The nutritional status of 47 patients was evaluated by weight, height, weight-loss, arm muscle circumference, triceps skin-fold measurements, serum albumin, pre-albumin, retinolbinding protein, tranferrin, and cholinesterase. In 35 patients protein catabolism was assessed by the urea production rate (catabolism greater than 15 g/d). Immunity was assessed by the total lymphocyte count and a skin reactivity test. Using these criteria, 55% of the patients were malnourished. Curative operations could only be carried out in 17.4% of the malnourished, but in 50% of the normally nourished patients (P less than 0.0001). Postoperative complications were increased in malnourished patients (47%) when compared with normally nourished patients (20%, P less than 0.05). In anergic and malnourished cancer patients no curative surgical treatment was possible. Due to the increased postoperative complication rate in malnourished cancer patients, nutritional assessment, including the determination of cellular immunity should be performed after admission.

Body Height↗
PubMed1981

[TSH-secretion after surgery of decompensated autonomous thyroid adenomas].

The postoperative secretion rate of TSH before and after stimulation by TRF was studied in 43 patients with hyperfunctioning thyroid adenomas. TSH secretion is reduced and not at all or insufficiently stimulated by TRF preoperatively. This condition normalizes six weeks after operation. Mainly in those patients, who needed extensive resections of thyroid parenchyma basal TSH concentration and stimulation by TRF were elevated postoperatively. Following enucleations of adenomas or small resections we do not perform a substitution therapy, but control TSH-secretion rates in yearly intervals.

Adenoma↗
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

[Conservative treatment of hyperthyroidism (author's transl)].

Antithyroid medication was given to 158 patients with hyperthyroidism over a period of 3 to 60 months. After cessation of therapy patients were followed up for 18 to 90 months. Permanent euthyroidism was seen in 70 patients (44.3%) after stopping treatment, however, 88 patients (55.7%) showed recurrence of hyperthyroidism occurring 1 to 56 months after ceasing treatment. In more than 50% recurrence of hyperthyroidism was within the first 3 months and in almost 80% within the first year after end of treatment. There was no connection either between the length of thyrostatic treatment and the recurrence rate or between the length of treatment and recurrence time. Comparison of patients with and without recurrence according to various parameters prior, during and after thyrostatic treatment indicates that there is a high risk of recurrence in patients with 1) nodular and (or) large goitres, 2) marked clinical symptomatology and delayed attainment of a euthyroid state after starting conservative treatment, and 3) the symptom of sweating remaining uninfluenced by antithyroid treatment.

Antithyroid Agents↗