Search PubMed⌕ Search

Biomedical subjects

G Paumgartner

Publications and source records attributed to G Paumgartner.

At least 163 records · Page 9Linked to original sources
PubMed1988

Somatostatin does not reduce oesophageal variceal pressure in liver cirrhotics.

Transmural oesophageal variceal pressure was determined by direct puncture of the varices in 27 patients with liver cirrhosis and oesophageal varices. Variceal pressure was not influenced three to six minutes after somatostatin bolus administration and slightly increased during somatostatin infusion. Thus, potential haemostatic benefits of somatostatin cannot be explained by pressure reductions in the varices.

Blood Pressure↗
PubMed1988

Stimulation of acid secretion and phosphoinositol production by rat parietal cell muscarinic M2 receptors.

The muscarinic receptor system involved in hydrogen ion production by enriched rat gastric parietal cells was investigated. Muscarinic receptor density determined by [N-methyl-3H]scopolamine binding was 8,100/cell. The receptor appeared to be of the M2 muscarinic receptor subtype, since it had a low affinity (Kd, 189 nM) for the M1 receptor antagonist pirenzepine compared with atropine (Kd, 0.74 nM). Receptor activation by carbachol rapidly augmented levels of polyphosphoinositides, indicating an activation of a phospholipase C. The dose-response relations for the increase in inositol phosphates closely paralleled the binding of carbachol to muscarinic receptors with a Km of 17 microM. The inositol phosphate response was antagonized by pirenzepine with a Ki of 177 nM. The stimulation of inositol phosphate levels by carbachol correlated well with the stimulation of [14C]aminopyrine uptake, determined as an index of acid secretion. The muscarinic agonists oxotremorine, pilocarpine, and bethanechol elicited partial increases in inositol phosphates at maximal drug concentrations, and these partial increases correlated with their ability to stimulate [14C]aminopyrine uptake. These data indicate that inositol polyphosphates may be a second messenger of M2 receptors stimulating acid secretion.

Aminopyrine↗
PubMed1988

Crohn's disease is frequently complicated by giardiasis.

Giardiasis is a common infection, and many of its symptoms are similar to those of Crohn's disease. Despite a long discussion on the role of microbiologic agents in Crohn's disease, giardiasis has never been investigated. We studied giardiasis as assessed by the occurrence of cysts in 86 patients with Crohn's disease, in 82 patients with other gastrointestinal disease, and in 52 patients without gastrointestinal disease. In addition, in 20 patients with Crohn's disease the effects of metronidazole on giardiasis and disease activity were studied. Frequency of giardiasis was 61.6% in patients with Crohn's disease, 31.7% in patients with other gastrointestinal disease, and 5.8% in the control group (p less than 0.01). Stool frequency, disease activity, and humoral signs of inflammation in patients with Crohn's disease showed no relationship to giardiasis. All but two patients treated with metronidazole became free of cysts. Crohn's disease activity index decreased in 14 of 20 patients (p less than 0.05). In conclusion, giardiasis is a common finding in patients with Crohn's disease. Treatment of giardiasis can, in individual cases of Crohn's disease, result in a quick recovery from symptoms of high disease activity.

Adult↗
PubMed1988

[Pathophysiologic and clinical relevance of atrial natriuretic factor in patients with cirrhosis of the liver].

Defects of the ANF system in cirrhosis have not been demonstrated in terms of absolute deficiency of plasma levels or by evidence of major abnormalities of processing in patients with cirrhosis. In the present study, the responsiveness of the ANF system to acute volume stimulation by water immersion and the diuretic and natriuretic effects of ANF infusion were examined. Stimulation of ANF release by 1-h immersion was significantly blunted in ten cirrhotic patients with ascites (increase of plasma ANF by 46 +/- 18%), whereas 11 cirrhotics without ascites showed a 104 +/- 16% increase, similar to the 117 +/- 29% stimulation in 25 healthy controls. Immersion increased urinary volume by 3.6 +/- 0.6/2.0 +/- 0.8/0.7 +/- 0.4 ml/min and urinary sodium excretion by 146 +/- 38/75 +/- 43/43 +/- 19 mumol/min in controls/cirrhotics without/cirrhotics with ascites. Infusion of ANF for 30 min prompted an increase in diuresis and natriuresis in seven cirrhotic patients, which was less marked in patients with ascites, as compared to patients without ascites. Thus, the stimulus response coupling for ANF may be impaired in patients with cirrhosis and ascites.

Ascites↗
PubMed1988

Accuracy of the whole body retention half-life of 75SeHCAT in the diagnosis of ileal dysfunction in patients with Crohn's disease.

The measurement of the whole body retention of the synthetic taurine conjugated trihydroxy bile acid 75SeHCAT has been suggested as a new clinical test for the function of the terminal ileum. Because of the frequent occurrence of ileal dysfunction in Crohn's disease (CD), the accuracy of the SeHCAT test was studied in 64 patients with CD in various clinical conditions. A positive test result (retention half-life less than 1.2 days) was seen in 48.4% of the patients with ileal involvement (true positive tests) whereas a negative test was seen in 33 of the 64 patients. In 21 of the 33 patients (63.6%) the test was false negative since ileal inflammation or resection was confirmed by radiology or endoscopy. In 14 of those 21 patients with false negative test results a stenosis of the intestinal lumen was diagnosed. At a specificity of 100% the sensitivity of the SeHCAT test was 59.6% and the efficiency was 67.2%. If patients with known stenosis were excluded sensitivity improved to 79.4%. In conclusion, calculation of the whole body retention half-life of SeHCAT does not seem to be a valuable screening test for the diagnosis of ileal dysfunction. In CD, a pathologic test result identifies ileal dysfunction with high accuracy.

Adult↗
PubMed1988

Lipid composition and cholesterol nucleation time in gallbladder bile of patients with cholesterol gallstones under choleretic treatment with Febuprol.

The effect of a new potent choleretic drug (Febuprol) on lipid composition and cholesterol nucleation time in gallbladder bile was studied in 8 patients with cholesterol gallstones. Nine untreated patients with cholesterol cholecystolithiasis and functioning gallbladder served as controls. Under Febuprol treatment (3 X 100 mg for 6-10 days) mean concentrations of total bile acids (125.4 vs. 59.5 mmol/l), phospholipids (46.1 vs. 25.6 mmol/l) and total lipids (10.4 vs. 5.9 g/dl) were significantly higher (p less than 0.01) than in controls. No significant difference between both groups was calculated for the mean values of cholesterol (17.8 vs. 13.3 mmol/l), cholesterol saturation index (1.5 vs. 2.1) and cholesterol nucleation time (2.1 vs. 2.6 days). Our findings are compatible with a choleretic effect of Febuprol but no alteration of the rapid cholesterol crystallisation in gallbladder bile of patients with cholesterol gallstones was found.

1-Propanol↗
PubMed1987

Diagnostic sensitivity of fasting and postprandial serum bile acids determined by different methods.

The diagnostic sensitivities of serum bile acids determined by three different methods in the fasting and in the postprandial state were compared in 43 patients with cirrhosis of the liver. When a method with high analytical sensitivity (capillary gas-liquid chromatography, GLC, or radioimmunoassay, RIA) was used, the serum concentrations of bile acids exhibited similar diagnostic sensitivities in the fasting state (GLC, 98%; RIA, 93%) and in the postprandial state (GLC, 95%; RIA, 93%). By contrast, when an enzymatic method with limited analytical sensitivity was employed, the diagnostic sensitivity of fasting serum bile acids was lower (79%) than that of postprandial serum bile acids (93%). The measurement of individual serum bile acids by GLC did not add any further diagnostic information. The results of this study demonstrate that the diagnostic sensitivity of serum bile acids strongly depends on the analytical method used.

Adult↗
PubMed1987

Quantitation of serum bile acids by isotope dilution with 13C-labelled homologs.

Quantitation of individual bile acids in serum can be carried out with radioimmunoassays or with gas chromatography. The most specific measurements are obtained with combined gas chromatography/mass spectrometry employing stable isotope labelled bile acids as internal standards. So far only the use of deuterated internal standards has been described for this purpose. 24-13C-labelled bile acids have not been used since correction for the natural abundance of the 13C contribution has to be made. Furthermore, the maximal degree of labelling of 13C-labelled bile acids is about 90%. This requires additional correction for the percentage of unlabelled molecules. Using 13C-labelled bile acids as internal standards and adequate corrections for isotope interferences we have measured individual serum bile acids in healthy volunteers by inverse isotope dilution with coefficient of variation (CV) values of 5.4-6.2% determined for the total procedure of sample preparation and analytical technique. In fasting serum of 15 healthy volunteers chenodeoxycholic acid averaged 0.98 +/- SD 0.77 mumol/l, cholic acid 0.49 +/- 0.39 mumol/l and deoxycholic acid 1.07 +/- 0.68 mumol/l. Two hours postprandially these values increased to 2.42 +/- 1.46 mumol/l for chenodeoxycholic acid, 0.81 +/- 0.45 mumol/l for cholic acid and 1.66 +/- 1.02 mumol/l for deoxycholic acid. These data agree well with those described in the literature obtained with deuterated internal standards. It may be concluded that 24-13C-labelled bile acids are suitable as internal standards for quantitation of serum bile acids, if corrections for isotope interferences are made.

Adult↗
PubMed1987

Simultaneous determination of pool sizes and fractional turnover rates, of deoxycholic acid, cholic acid and chenodeoxycholic acid in man by isotope dilution with 2H and 13C labels and serum sampling.

This paper describes a method for simultaneous determination of the kinetics of the three major bile acids in man using (2,2,4,4-2H4) deoxycholic acid, (24-13C) cholic acid and (24-13C) chenodeoxycholic acid. The gas chromatographic/mass spectrometric-selected ion monitoring technique used provided complete separation of deoxycholic acid, cholic acid and chenodeoxycholic acid, which permitted simultaneous measurement of isotope ratios for all three bile acids. Since measurement of all three pool sizes and fractional turnover rates in a single experiment requires different isotopic labels for deoxycholic acid and cholic acid, we investigated the in vivo stability and applicability of (2,2,4,4-2H4) deoxycholic acid as a stable isotope marker for isotope dilution studies in man. No consistent differences were observed between deoxycholic acid pool sizes and fractional turnover rates determined in serum samples after administration of (2,2,4,4-2H4) deoxycholic acid and (24-13C) deoxycholic acid. Simultaneous administration of (2,2,4,4-2H4) deoxycholic acid, (24-13C) cholic acid and (24-13C) chenodeoxycholic acid and isotope ratio measurements in serum permitted determination of pool sizes and fractional turnover rates of the three major bile acid and the 7 alpha-dehydroxylation fraction. Pool sizes, fractional turnover rates and synthesis rates (input rates) agreed well with data obtained previously with (24-13C) labels in independent studies.

Carbon Isotopes↗
PubMed1987

Atrial natriuretic factor. Possible implications in liver disease.

The discovery of the first well-defined natriuretic hormone, the Atrial Natriuretic Factor (ANF), has prompted research on its impact on volume regulation in health and disease. The natriuretic, diuretic, and smooth muscle-relaxing properties suggest an important role of this novel hormone in pathophysiological states with sodium or volume retention, such as congestive heart failure or cirrhosis of the liver. Investigations on the implications of ANF in liver disease have been performed for little more than 1 year, and results are still controversial in many respects. At present, it seems very likely that there is no absolute deficiency of plasma ANF in patients with cirrhosis. Moreover, elevated plasma levels in cirrhotics with ascites have been reported by several groups. However, as yet, a molecular characterization of this increased immunoreactivity is still lacking. There is disagreement on the reduced release of and renal response to ANF in subgroups of cirrhotics; however, stimulus-response-coupling might be impaired. Further studies are needed to elucidate the pathophysiological implications and therapeutical potential of ANF in patients with chronic liver disease.

Atrial Natriuretic Factor↗
PubMed1987

Injection sclerotherapy of oesophageal variceal haemorrhage. A prospective long-term follow-up study.

One-hundred-seventy-five patients with oesophageal variceal bleeding and liver cirrhosis who underwent long-term injection sclerotherapy were prospectively followed for 44 +/- SD 17 months. While aetiology (alcoholic vs. non-alcoholic cirrhosis) had no influence on survival, the Child status assessed at the time of initiation of sclerotherapy was of important prognostic value (mortality rate after a mean follow-up of 44 months: Child A 5%, Child B 45%, and Child C 83%). Initiation of sclerotherapy (elective vs. emergency) had no influence on survival in the A/B patients, whereas electively treated Child C patients had a somewhat better outcome than those in whom sclerotherapy was started during active bleeding. Rebleeding, especially within the first two months after starting repeat sclerotherapy, was significantly influenced by the Child status of the patients. About one-fourth of all deaths were combined with rebleeding in the Child B and C patients, but none of the A patients had intestinal bleeding prior to death. It is concluded that Child A patients have an excellent long-term prognosis after variceal haemorrhage treated by repeated endoscopic injection of the varices.

Adolescent↗
PubMed1987

Disintegration of a pancreatic duct stone with extracorporeal shock waves in a patient with chronic pancreatitis.

We report the case of a 33-year-old woman with chronic calcifying pancreatitis in whom an intraductal pancreatic stone with a diameter of 8 mm was successfully disintegrated with extracorporeal shock waves, permitting subsequent endoscopic extraction of the fragments. The patient had a mild attack of pancreatitis after the treatment. We conclude that shockwave lithotripsy of a pancreatic duct stone in patients with chronic pancreatitis is possible. It should, however, be viewed with reservation until further experience has been gained.

Adult↗