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Biomedical subjects

G Rosenbusch

Publications and source records attributed to G Rosenbusch.

At least 37 records · Page 2Linked to original sources
PubMed1994

Effect of bile salt binding or protease inactivation on plasma cholecystokinin and gallbladder responses to bombesin.

BACKGROUND/AIMS: Bombesin-stimulated plasma cholecystokinin levels decrease after an initial increase despite continuous infusion of bombesin. The aim of this study was to determine if a feedback mechanism, mediated by bile salts or proteolytic enzymes, is responsible for this decline. METHODS: Bombesin (1.0 ng.kg-1.min-1) was infused into volunteers for 180 minutes on separate occasions. Cholestyramine, colestipol, camostate, or saline were perfused intraduodenally during the second hour of the tests. Cholestyramine was also administered without infusion of bombesin. RESULTS: Colestipol and cholestyramine, dependent on their bile salt-binding capacity, markedly enhanced (P < 0.05) bombesin-stimulated plasma cholecystokinin from 2.1 +/- 0.5 pmol/L to 6.4 +/- 2.2 pmol/L and 12.1 +/- 3.3 pmol/L (P < 0.05 vs. colestipol), respectively, and further decreased gallbladder volume (P < 0.05) from 9.4 +/- 1.6 mL to 2.0 +/- 0.4 mL and 2.2 +/- 0.5 mL, respectively. The protease inhibitor camostate had no effect. Bile salt precipitation also enhanced plasma pancreatic polypeptide responses (P < 0.01) but did not alter gastrin responses. Plasma cholecystokinin responses to cholestyramine without bombesin infusion varied considerably, but increments were highly correlated to decreases in gallbladder volume (r = 0.91; P < 0.005). CONCLUSIONS: Bile salt sequestration but not protease inactivation enhances plasma cholecystokinin and gallbladder responses to bombesin infusion in humans.

Adult↗
PubMed1994

Contemporary radiological examination of the small bowel.

There are clinical data suggesting that the intubation method (enteroclysis) is the most accurate form of examining the small bowel. The diagnostic accuracy of small bowel enema is generally found superior to that of the tubeless method. Despite the growing interest in small bowel enema this procedure has not yet become the prevailing method in Western countries. However, due to further developments in sonde or push enteroscopy in which 300 cm of the small bowel can be visualized, it is of utmost importance to perform state of the art radiological small bowel enteroclysis investigation, otherwise the bright lights from enteroscopy will rapidly illuminate the dark corners of the small intestine, leaving no place for radiology.

Barium Sulfate↗
PubMed1994

Contemporary radiological examination of the lower gastrointestinal tract.

The morphological spectrum of colonic disease is wide. Various treatment modalities may influence the macroscopic aspect of colonic lesions and render a pathological differential diagnosis occasionally difficult or impossible. Before starting therapy in patients suspected of having colonic disease, a physician should undertake a thorough radiological and endoscopic evaluation of the extent and severity of disease activity in the large bowel (Ruderman and Farmer, 1987). DCBE and colonoscopy are complementary imaging modalities, each test has its own intrinsic advantages and merits (Lichtenstein and Rothstein, 1991). DCBE remains the cornerstone in the detection of fistulas, strictures, perforations and estimating depth of ulcerations. Colonoscopy and biopsy remain the most sensitive imaging modalities to identify mucosal involvement (Dijkstra, 1992). The main clinically relevant discrepancies between colonoscopy and DCBE consist of inflammatory lesions without distortion of the mucosal relief and inflammation in the form of small, superficial erosions and ulcers (Dijkstra, 1992).

Barium Sulfate↗
PubMed1994

Preliminary results of endorectal surface coil magnetic resonance imaging for local staging of prostate cancer.

OBJECTIVE: To evaluate the effectiveness of endorectal surface coil (ERC) magnetic resonance imaging (MRI) in the local staging of adenocarcinoma of the prostate (ACP). MATERIALS AND METHODS: A total of 23 patients who were considered candidates for radical prostatectomy because of clinically localized ACP were examined by ERC-MRI. All patients underwent laparoscopic or open lymph-node dissection prior to surgery. Four patients had positive lymph nodes at operation. A total of 19 underwent radical prostatectomy, allowing comparison of the MRI data with the surgical pathologic findings. RESULTS: Twelve patients had extraglandular spread of ACP (T3) and 7 had locally confined ACP (T2). ERC-MRI predicted correctly a T3 tumor in 10 of 12 cases and a T2 tumor in 4 of 7 cases. ERC-MRI was 74% accurate in differentiating T2 from T3 tumor. Three cases of overestimation were in studies with poor image quality because of bowel movement motion artifacts. CONCLUSION: ERC-MRI was found to be a sensitive modality in staging clinically localized ACP.

Adenocarcinoma↗
PubMed1994

[The value of CT for the diagnosis of rectal cancer recurrence. A ROC study and a retrospective analysis].

To assess the ability of CT to detect recurrent tumor growth after colorectal surgery for rectal carcinoma independently of clinical bias and patient selection, a receiver operator characteristic (ROC) analysis was performed. A set of 100 CT scans, 50 scans of 35 patients with proven recurrent disease, and 50 normal postoperatives of 37 patients were read by four observers without knowledge of the present clinical status. The four ROC curves had an area under the curve (AUC) ranging from 0.69 to 0.78 (SD from 0.046 to 0.053). The slightly raised AUC indicates the poor diagnostic power of CT in discriminating between postoperative changes and recurrence. In a retrospective analysis of the CT scans of the 72 patients CT had an overall accuracy of 83%. CT was unable to detect small anastomotic recurrence. The morphological characteristics of recurrence were not specific, but an irregular globular mass with or without inhomogeneity or asymmetry strongly suggests recurrent tumor and stresses the need for further evaluation, e.g., CT-guided biopsy.

Female↗
PubMed1993

[Midgut malrotation. What is involved?].

To make an inventory of radiological findings involved in midgut malrotation, 56 consecutive patients with surgically proven isolated malrotation of the midgut were evaluated retrospectively. Findings on plain abdominal radiography, upper gastrointestinal series, radiography after barium enema, ultrasound and/or computed tomography (CT) were reviewed, correlated with findings at surgery and classified into clinical entities related to embryological development. Findings were normal in 20/45 plain abdominal radiograms, 2/46 upper gastrointestinal series, 9/43 radiograms after barium enemas, and 9/13 ultrasound and/or CT examinations. All other examinations showed a multitude of abnormalities, which are discussed in depth. Complete radiological classification into the aforementioned clinical entities was possible in 33 patients (58.9%). Partial classification was possible in the remaining patients (23/56; 41.1%). It is concluded that midgut malrotation is a treacherous disease with multivarious clinical symptoms. Use of the classification described makes it easier to interpret the findings.

Adolescent↗
PubMed1993

[Is peritoneography indicated for the diagnosis of inguinal and abdominal wall hernias?].

The role of herniography in patients with unexplained pain in the groin or anterior abdominal wall is discussed and referred to that of other imaging modalities. The technique of herniography, its indications and contraindications, and anatomical aspects are dealt with. A series of 81 patients who underwent herniography is presented and the results are correlated with findings at surgery.

Adult↗
PubMed1993

[Endosonography of the esophagus and the stomach].

Endosonography of the oesophagus and stomach is important for staging of carcinomas, for judging the degree of thickening of the wall, and for assessment of submucosal and intramural lesions and of space-occupying processes in extra-oesophageal and extragastric organs.

Endoscopy↗
PubMed1993

[Rectal endosonography for perirectal and non-tumor rectal changes].

The value of rectal endosonography was retrospectively evaluated in 39 patients with various rectal and perirectal diseases. Endosonography proved to be very helpful in demonstrating or excluding abscesses. In patients with aspecific minor inflammatory rectal diseases, endosonography was not very helpful. Endosonography is complementary to other imaging techniques like CT and MRI in establishing perirectal tumors. Endosonography shows the relationship of the rectal wall with an extrarectal tumor and is capable of demonstrating the extent of smaller tumors. It may contribute to the diagnosis of endometriosis in the rectovaginal space. In patients with anal pain endosonography can play an important role in demonstrating or excluding fistulas, abscesses and other diseases.

Abscess↗
PubMed1992

Postprandial gallbladder motility and plasma cholecystokinin at regular time intervals after injection of octreotide in acromegalics on long-term treatment.

The increased risk of gallstone formation in acromegalics treated with the somatostatin analog octreotide has been related to an impaired gallbladder emptying. To determine the duration of these inhibitory effects, meal-stimulated gallbladder motility, plasma cholecystokinin (CCK), and pancreatic polypeptide (PP) were measured in five acromegalics treated for 6-32 months with 200-300 micrograms octreotide daily. Meal tests were performed 45 min, 8 hr and two weeks after the last 100-micrograms subcutaneous dose. Results were compared with those in normal subjects. Integrated postprandial gallbladder contraction (-125 +/- 194 cm3/120 min) and integrated PP secretion (-0.1 +/- 0.2 nmol/liter/120 min) were completely suppressed in the 45-min study, but significantly improved (P < 0.05) when measured 8 hr (1376 +/- 322 cm3/120 min and 3.0 +/- 1.0 nmol/liter/120 min) and two weeks (1437 +/- 263 cm3/120 min and 10.6 +/- 1.6 nmol/liter/120 min) after the last dose of octreotide. The integrated gallbladder contraction in acromegalics at 8 hr was comparable to that at two weeks and to that in normal subjects, but the integrated PP response at 8 hr was significantly smaller (P < 0.05 vs two weeks and vs normals). Integrated plasma CCK secretion at 45 min (0.13 +/- 0.06 nmol/liter/120 min) was not statistically significantly different from the response at 8 hr (0.15 +/- 0.02 nmol/liter/120 min) and from that in normal subjects, but it was significantly increased at two weeks after cessation of octreotide (P < 0.05 vs 45 min and 8 hr).(ABSTRACT TRUNCATED AT 250 WORDS)

Acromegaly↗
PubMed1992

Doppler ultrasound scanning in the detection of renal artery stenosis in hypertensive patients.

The diagnostic accuracy of Doppler ultrasound in the detection of renal arterial disease has been assessed in a prospective study of 61 hypertensive patients. The findings of Doppler ultrasound were compared with the results of renal angiography. In 15 patients (24.5%) no accurate Doppler signs could be obtained and the Doppler ultrasound examination was considered a technical failure. Of the remaining 46 patients, 24 had renal artery stenosis. Nine of the stenoses were not detected by Doppler ultrasound and in three patients a false positive diagnosis of renal artery stenosis was made. The sensitivity of Doppler ultrasound was 62.5%, the specificity 86.4% and the overall diagnostic accuracy was 73.9%. By comparing the 15 patients in whom Doppler ultrasound failed with the 46 in whom it was successful, age appeared to be higher and creatinine clearance lower in the failure group. By comparing the 34 patients with true positive and true negative results with the 12 patients with false results, no significant differences were found. In a multivariate analysis, higher age showed a significant relation to failure of Doppler ultrasound. Doppler ultrasound has limited value in the screening of hypertensive patients for renal artery stenosis.

Female↗
PubMed1992

Pancreatic morphology and function in adult patients with cystic fibrosis.

To determine the relation between pancreatic morphology and pancreatic exocrine and endocrine function, we have studied 8 adult cystic fibrosis patients and 14 normal control subjects by ultrasonography and pancreatic function testing. In the patients with cystic fibrosis the maximum anteroposterior diameter of the pancreatic head was significantly increased over that in control subjects (p less than 0.01), whereas the maximum diameter of the body was significantly decreased (p = 0.05). Increased echogenicity of the pancreatic body was observed in most patients. In the cystic fibrosis patients postprandial insulin secretion was reduced in the 1st h (p less than 0.005 versus control), whereas pancreatic polypeptide secretion was virtually abolished for at least 3 h (p less than 0.01 versus control). All cystic fibrosis patients had evidence of exocrine pancreatic dysfunction as reflected by a diminished urinary para-aminobenzoic acid excretion. Intraduodenal enzyme and bicarbonate output in response to secretin-cholecystokinin was reduced in all of three patients studied. It is concluded that loss of endocrine and exocrine pancreatic function in adult cystic fibrosis patients is accompanied by a small and echo-dense pancreatic body relative to a large pancreatic head.

4-Aminobenzoic Acid↗
PubMed1991

Increased plasma cholecystokinin levels and small gall bladders in adult patients with cystic fibrosis.

1. In patients with cystic fibrosis, abnormalities in plasma cholecystokinin level and gall-bladder emptying may contribute to the development of maldigestion and gall-stones. 2. Therefore, we have measured plasma cholecystokinin levels and gall-bladder volumes before and after ingestion of a standard breakfast in eight adult patients with cystic fibrosis and in eight normal control subjects. 3. In the patients with cystic fibrosis basal (2.8 +/- 0.4 pmol/l; P less than 0.05, t-test) and maximum post-prandial (5.7 +/- 0.5 pmol/l; P less than 0.05, t-test) plasma cholecystokinin levels were significantly higher than those in the control subjects (1.9 +/- 0.1 pmol/l, and 4.5 +/- 0.2 pmol/l, respectively). On the other hand, integrated plasma cholecystokinin secretion in response to the meal was similar (t-test, P = 0.4 versus control subjects). The increased plasma cholecystokinin levels in the patients with cystic fibrosis were accompanied by reduced gallbladder volumes in both the basal (7.8 +/- 2.1 cm3 versus 20.9 +/- 2.3 cm3 in control subjects; P less than 0.005, t-test) and the post-prandial state (2.2 +/- 1.0 cm3 versus 4.8 +/- 0.8 cm3 in control subjects; P = 0.06, t-test). Gall-bladder emptying in the patients with cystic fibrosis was well preserved (70 +/- 7% versus 78 +/- 9% in control subjects; P = 0.4, t-test). 4. In comparison with normal control subjects, patients with cystic fibrosis have an increased basal plasma cholecystokinin level and a reduced gall-bladder volume, whereas post-prandial gall-bladder emptying and plasma cholecystokinin secretion are not significantly different.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

The effect of caffeine on renal vein renin concentration in patients with renal arterial disease.

The aim of this study was to investigate whether caffeine stimulates selectively renal vein renin levels at the side of unilateral stenosis in patients with renovascular hypertension. In this study seven of the involved patients had renal arterial stenosis and four had no stenosis. Four of the seven patients with a stenosis had retrospectively-proven renovascular hypertension. Renal vein renin sampling was performed before and after intravenous administration of caffeine. Caffeine did not induce any consistent effect on plasma renin activity in the renal veins, either on the stenotic side or on the contralateral side in patients with renovascular hypertension. There were no consistent caffeine mediated changes in systemic plasma renin activity.

Caffeine↗
PubMed1990

Role of cholecystokinin and the cholinergic system in intestinal stimulation of gallbladder contraction in man.

To determine the role of cholecystokinin and the cholinergic system in intestinal stimulation of gallbladder contraction, we studied the effects of atropine on plasma cholecystokinin and gallbladder contraction in six healthy volunteers (four men and two women aged 20 to 27 yr). Effects were noted after intraduodenal fat instillation and after dosage with exogenous cholecystokinin inducing plasma cholecystokinin concentrations similar to those after intraduodenal fat instillation. At regular intervals before and after administration of each stimulus, plasma cholecystokinin concentrations and gallbladder volumes were measured by radioimmunoassay and real-time ultrasonography, respectively. Intraduodenal infusion of 250 ml 20% Intralipid induced a peak plasma cholecystokinin increment of 10.2 +/- 1.6 pmol/L compared with 10.7 +/- 0.7 pmol/L during infusion of 1 Ivy dog unit per kilogram per hour of cholecystokinin. The increases in plasma cholecystokinin after fat and exogenous cholecystokinin administration were accompanied by similar decreases in gallbladder volume. Integrated gallbladder contraction after fat instillation was 3,939% +/- 288%.min compared with 3,301% +/- 359%.min during cholecystokinin infusion (NS). Atropine (0.015 mg/kg as bolus followed by 0.005 mg/kg/hr) did not change plasma cholecystokinin concentrations but induced similar inhibition of gallbladder contraction to 2,296% +/- 511%.min (p less than 0.05) after intraduodenal fat instillation and to 1,756% +/- 456%.min (p less than 0.05) during cholecystokinin infusion. We conclude that cholecystokinin is of major importance in intestinal stimulation of gallbladder contraction. Atropine inhibits the gallbladder response to intraduodenal fat. This inhibition is not due to a reduction in cholecystokinin secretion but to a diminished gallbladder response to cholecystokinin.

Adult↗
PubMed1990

Effect of increasing oral doses of loperamide on gallbladder motility in man.

1. Loperamide, a peripherally acting opiate receptor agonist with antidiarrhoeal action, inhibits ileal and colonic motor function. To determine the effect of loperamide on gallbladder motility, we have pretreated five healthy volunteers with 2 mg oral loperamide 24 h, 20, 12 and 2.5 h before; six healthy volunteers with 16 mg oral loperamide 2.5 h before; and eight healthy volunteers with 16 mg oral loperamide 12 and 2.5 h before intravenous infusion of a 'physiological dose' of 12.5 pmol kg-1 cholecystokinin (CCK) for 1 h to stimulate gallbladder contraction. All subjects served as their own controls. Gallbladder volume was measured by ultrasonography and plasma CCK by radioimmunoassay until 90 min after start of the CCK infusion. 2. Infusion of CCK resulted in plasma CCK concentrations similar to those after intraduodenal fat. Integrated gallbladder contraction after 4 X 2 mg loperamide (4600 +/- 891% min) was similar to that without pretreatment (5270 +/- 1037% min; NS). Integrated gallbladder contraction after 1 X 16 mg loperamide diminished from 5458 +/- 412% min without to 2632 +/- 816% min with loperamide (P less than 0.05), and was completely abolished to -596 +/- 762% min (P less than 0.0005 vs without loperamide) after 2 X 16 mg loperamide. 3. It is concluded that loperamide inhibits gallbladder contraction in response to a physiological dose of cholecystokinin in a dose-dependent manner.

Adult↗
PubMed1990

Postprandial exocrine pancreatic function during long-term treatment with the somatostatin analogue SMS 201-995 in acromegalic patients.

Long-term treatment with the somatostatin analogue SMS 201-995 (SMS) might impair exocrine pancreatic function, secretion of cholecystokinin (CCK) and pancreatic polypeptide (PP), and pancreatic size. In five acromegalics on chronic treatment with SMS, we investigated postprandial 6-h urinary excretion of p-aminobenzoic acid (PABA) and p-aminosalicylic acid (PAS) after s.c. injection of 100 micrograms SMS or placebo and after ingestion of 2 mmol nBT-PABA and 2 mmol PAS. In the acromegalics, urinary PABA/PAS ratio (reflecting exocrine pancreatic function) after SMS was similar to that after placebo (P greater than 0.10) and higher than in healthy volunteers (n = 8, P = 0.05). The initial inhibition of plasma CCK secretion by SMS was cancelled during the 3rd h after the meal, whereas PP release remained completely abolished. Pancreatic size as measured by ultrasonography, was not reduced in seven acromegalics compared with 14 healthy volunteers. It is concluded that despite a blunted release of the trophic hormone CCK, long-term treatment with SMS 201-995 neither induces an abnormally small pancreas nor deterioration of postprandial exocrine pancreatic function in patients with acromegaly.

4-Aminobenzoic Acid↗