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Biomedical subjects

G Stacher

Publications and source records attributed to G Stacher.

At least 91 records · Page 5Linked to original sources
PubMed1983

[Swallowing the psyche].

Various swallowing disorders have been viewed to be psychogenic and an altered contractile activity of the oesophagus has been reported to occur during emotional stress. Non-propulsive activity and "cardiospasm" were suggested to represent a symbolic revulsion, referring to deep, unconscious conflict or an ambivalent attitude towards incorporation (Kronfeld, 1934; Weiss, 1944; Alexander, 1950). However, these concepts were not corroborated by subsequent research. "Globus hystericus" was shown to result from webs and folds in the hypopharynx or from gastrooesophageal reflux, whilst the term "cardiospasm" has even become obsolete: there is no spasm of the lower oesophageal sphincter but an "achalasia", i.e., a failure to relax upon swallowing, which is not induced by psychic factors, but by lesions affecting the intrinsic and extrinsic innervation. On the other hand, it has been shown that the oesophagus reacts with non-propulsive contractions not only emotional tension, but also to cold or hot food and even to stimuli not related to ingestion such as intense short sounds, and that these contractions are likely to form part of the defence reaction of the healthy organism. Despite this responsiveness of the oesophagus and the fact that strategies aimed at inducing relaxation and reassurance can help patients to cope with their swallowing disorders, the psychosomatic concept that "exaggerated" oesophageal responses can lead to organic diseases has remained purely speculative. Present knowledge of the physiology and pathophysiology of the oesophagus clearly indicates that disorders such as globus sensation, achalasia, and diffuse oesophageal spasm should not be treated by psychotherapeutic but by appropriate surgical, or medical, means.

Acoustic Stimulation↗
PubMed1983

Effects of graded oral doses of meptazinol and pentazocine in comparison with placebo on experimentally induced pain in healthy humans.

The opioid agonist/antagonist meptazinol has proven to exert significant analgesia in a series of painful conditions. This study investigated the effects of single oral doses of meptazinol 100, 200, and 400 mg in comparison with pentazocine 50 and 100 mg and with placebo on experimentally induced pain. In addition, the side effect profiles were assessed. Twenty-four healthy subjects participated each in six experiments in which they received, in random double-blind fashion, each of the treatments. Every experiment comprised 10 series of measurements, two before and eight after drug administration, carried out at 30 min intervals. Meptazinol produced significant dose-related increases of threshold and tolerance to electrically and thermally induced pain. Meptazinol 400 mg was significantly superior to placebo in all pain measures and proved as effective as pentazocine 50 and 100 mg, which yielded about equal effects. Meptazinol 200 mg was significantly weaker than pentazocine 50 mg and differed significantly from placebo only in its effects on pain tolerance. Meptazinol did not cause any severe side effects or systematic alterations of respiration, blood pressure, heart rate and central nervous functions. Pentazocine caused a higher number and more severe side effects, one subject reporting severe dysphoria after pentazocine 100 mg. The results give further evidence that meptazinol is well suited to replace other opioid analgesics compromised by a high incidence of adverse effects.

Adult↗
PubMed1982

Effects of a combination of oral naproxen sodium and codeine on experimentally induced pain.

The effect of an orally administered combination of naproxen sodium 550 mg and codeine phosphate 60 mg on threshold and tolerance to electrically induced pain, and on the threshold to thermally induced pain, was compared with the effects of naproxen sodium 550 mg alone, codeine phosphate 60 mg alone, and placebo. 16 female and 16 male, healthy young subjects, took part in four experiments on consecutive days of one week. On each day one treatment was administered, in random order, under double blind conditions. The combination increased threshold and tolerance to electrically induced pain and the threshold thermally induced pain markedly more than did naproxen sodium alone. Naproxen sodium plus codeine was also more effective in increasing threshold and tolerance to electrically induced pain than was codeine alone; the latter increased the threshold and tolerance to electrically induced pain and the threshold to thermally induced pain markedly more than placebo. Naproxen sodium alone had a relatively weak effect on the three pain measures. Reaction time to acoustic stimuli and the side effect profile were not significantly influenced by any of the treatments, and no severe adverse effects occurred. It is concluded that the combination of naproxen sodium 550 mg and codeine phosphate 60 mg, as indicated by its effects on experimentally induced pain, can produce more intense analgesia than the same doses of naproxen sodium and codeine administered alone, and that naproxen sodium and codeine phosphate given in combination enhanced each other's effect in an additive manner.

Adult↗
PubMed1982

Effects of oral pirenzepine on gastric emptying and antral motor activity in healthy man.

UNLABELLED: Pirenzepine (PIR), in contrast to classical antimuscarinic drugs, shows heterogeneity of binding that corresponds with the pharmacological activity: gastric secretion is inhibited by low doses, whereas higher doses are needed to inhibit gastrointestinal motility. This study investigated the effects of oral PIR on gastric emptying and antral motor activity. 20 healthy men (mean age 24.9 yr) participated in two experimental sessions, one week apart. According to a cross-over double blind design they received, three and a half days prior to the studies, either 50 mg PIR twice daily or placebo (PLA). A semisolid test meal labelled with 150 MBq 99mTc hSA was administered. A gamma camera coupled to a computer monitored modulation depth (MD), frequency (FR), and propagation velocity (PV) of antral contractions together with gastric emptying rate (GE) according to a modification of Akkerman's technique. PIR decreased MD (PLA: 21.2 +/- 1.7 SEM%; PIR: 17.2 +/- 1.5%; P less than 0.005) and increased FR (PLA: 3.12 +/- 0.05 cycles/min; PIR: 3.29 +/- 0.07 c/min; P less than 0.005) significantly whereas PV was accelerated (PLA: 2.9 +/- 0.2 mm/sec; PIR: 3.1 +/- 0.3 mm/sec; n.s.) and GE delayed only slightly (PLA: 50.4 +/- 8.5 kcpm; PIR: 35.5 +/- 6.0 kcpm; n.s.). PIR produced more frequent stools in three and accommodation difficulties and a dry mouth in each two subjects. PLA caused no side effects. CONCLUSION: PIR delays GE insignificantly despite of considerable effects on antral motility.

Adult↗
PubMed1982

Dose-related effects of the synthetic met-enkephalin analogue FK 33-824 on esophageal motor activity in healthy humans.

The effects of FK 33-824, a methionine enkephalin analogue, 313, 625, 1250, 2500, and 5000 ng/kg body wt intramuscularly, on esophageal motor activity and cardiovascular and central nervous functions were studied in 8 healthy men. In the lower one-third of the esophagus, amplitude and duration of swallow contractions increased dose-dependently within 15 min after administration. In the middle one-third, amplitudes increased only slightly, whereas no systematic changes occurred in the upper one-third. The propagation velocity of the deglutitive wave accelerated dose-dependently between 15 and 10 cm as well as between 10 and 5 cm above the lower esophageal sphincter, the acceleration being more pronounced in the distal segment. Heart rate and systolic and diastolic blood pressure increased dose-relatedly, while no effects were found on electroencephalogram and reaction time. These results, together with earlier findings, support the notion of a participation of enkephalins in the regulation of the smooth muscle esophagus.

Adult↗
PubMed1981

Stimulatory effects of the synthetic enkephalin analogue FK 33-824 on colonic motor activity antagonized by naloxone.

Enkephalins inhibit guinea pig ileum contractions in vitro; in vivo they increase gastric contraction strength and small intestinal spike activity in dogs and stimulate tonic and phasic contractile activity of the human colon. This study investigated the question as to whether the stimulatory effect of the synthetic met-enkephalin analogue FK 33-824 on the human colon is antagonized by the narcotic antagonist naloxone. On 3 experimental days 12 healthy young males received in random order (a) 4 mg (subjects 1-6) or 10 mg (subjects 7-12) naloxone i.v. followed by 1 mg FK 33-824 i.m., (b) saline i.v. followed by 1 mg FK 33-824 i.m. and (c) saline i.v. followed by saline i.m. FK 33-824 following saline produced a rapid increase of tonic intraluminal pressure (mean increase: 9.9 +/- 2.5 SEM mmHg; P less than 0.001), an increase in contractions from 1.6 +/- 0.4 to 3.3 +/- 0.8 per min (P less than 0.001), a shift in the dominant frequency of rhythmic contractions from 1.0 +/- 2.5 to 2.5-3.5 cycles per min, an increase in the amplitude of contractions from 10.1 +/-0 2.1 to 15.0 +/- 3.2 mmHg (P less than 0.01), and in the sum of the amplitudes as an overall measure of contractile activity from 148.6 +/- 36.7 to 482.9 +/- 136.9 mmHg (P less than 0.01). All effects lasted for more than 70 min; peak changes occurred in the first 15 min and subsided slowly in intensity. The effects of FK 33-284 were greatly attenuated by premedication of 4 mg naloxone, and abolished, at least for 15-30 min, by 10 mg naloxone. Saline caused no changes. It is concluded that the stimulatory effects of FK 33-824 on human colonic motility are antagonized by naloxone.

Adult↗
PubMed1979

[Reconstruction of abdominal wall defects using corium. Surgical procedure, clinical results and manometric examination of postoperative abdominal wall function].

Extensive resection of the abdominal wall was performed on six patients to reconstruct defects caused by tumors or necroses. Autologous dermis covered by a flap plasty produced good clinical and functional results, documented by the measurement of intraabdominal pressures in response to coughing, pressing, and lifting of the legs. The autologous dermis graft represents a valuable tool for the closure of large defects of the abdominal wall.

Abdominal Muscles↗
PubMed1979

Effects of tolmetin, paracetamol, and of two combinations of tolmetin and paracetamol as compared to placebo on experimentally induced pain. A double blind study.

Previous studies in animals suggested that a coadministration of the anti-rheumatic/anti-inflammatory agent tolmetin (Tolectin) and of paracetamol potentiates the effects of these two drugs. The present study was carried out to assess whether or not the dosis of tolmetin necessary to obtain an analgesic effect can be reduced when paracetamol is coadministered in a model with experimentally induced pain in healthy human subjects. The effects of tolmetin 200 mg (T 200), paracetamol 400 mg (P 400), tolmetin 150 mg plus paracetamol 300 mg (T 150 + P 300), and of tolmetin 100 mg plus paracetamol 400 mg (T 100 + P 400) on pain threshold to electrical and thermal stimuli and on pain tolerance to electrical stimuli were compared to the effects of placebo under double blind conditions. Each of 20 healthy volunteers received all of the 5 treatments randomised according to four 5 X 5 Latin squares. The results showed that the combination T 100 + P 400 had better analgesic effects than the double dose of tolmetin, T 200, alone, while the effects of P 400 could not be discrminated from placebo. In a sequential t-test the effects of T 100 + P 400 could be discriminated from placebo already after 14 Ss. The effects of T 200, T 150 + P 300, and T 100 + P 400 respectively could not be differentiated, indicating that the dose of tolmetin can be reduced markedly by simultaneous administration of paracetamol without a loss in analgesic potency. Coadministration of tolmetin and paracetamol permits a marked reduction of the dose of tolmetin without any loss of analgesic potency as measured in a model with experimentally induced pain in healthy subjects.

Acetaminophen↗
PubMed1979

Tertiary esophageal contractions evoked by acoustical stimuli.

"Spontaneous" tertiary esophageal contractions occur in a high proportion of healthy subjects. This study was carried out to investigate whether such contractions can be elicited by acoustical stimuli, to determine the threshold intensity at which contractions occur, and to find out how many of a sequence of equiintense tones at such a threshold intensity evoke contractile responses. Esophageal pressures were recorded 5, 10, and 15 cm above the lower esophageal sphincter, and swallowing was recorded by an electromyogram of the mylo-hyoid muscles. The results are summarized as follows: (a) All of 22 subjects exposed to 1000 Hz tones of intensities between 70 and 125 dBA responded with teritary contractions; their mean threshold intensity was 86.8 dBA +/- 3.0 SEM. Intensities that were 5 to 20 dBA higher were necessary to evoke contractions also in response to a second tone of a given intensity. (b) In 36 to 40 subjects exposed to 40 1000 Hz, 90 dBA tones tertiary contractions occurred in response to 47.2% of stimuli presented. (c) On repetitive stimulation, there was a significant decrease in number and amplitude of esophageal responses with an increasing number of stimuli. It is concluded that the esophagus takes part in the response system of the healthy organism to environmental stimuli.

Acoustic Stimulation↗
PubMed1979

The effect of intramuscular pirenzepine on esophageal contractile activity and lower esophageal sphincter pressure under fasting conditions and after a standard meal. A double blind study.

In two studies, each on 16 healthy volunteers, the effects of pirenzepine on esophageal and lower esophageal sphincter (LES) contractile activity were studied under double blind conditions. One study was carried out on subjects who had fasted, the other on subjects who had ingested a standard meal. Each subject underwent two experiments, one with i.m. injection of 0.2 mg/kg body weight pirenzepine, the other with an injection of solvent. Heart rate, respiratory rate, electroencephalogram, and reaction time to acoustical stimuli were recorded to control for cardiovascular, respiratory and central nervous effects respectively. Pirenzepine under both fasting and nonfasting conditions caused significant decreases in number, amplitude, and duration of swallow-contractions. LES pressures under both conditions were significantly lower after pirenzepine than after the solvent. Pirenzepine furthermore caused a significant heart rate deceleration and respiratory acceleration, as well as an increased power in the faster Beta- and decreased power in the Alpha-range of the EEG. In conclusion, pirenzepine inhibits esophageal and LES contractile activity and also affects the central nervous system by a direct or indirect mechanism. An application of pirenzepine in hypertensive states of the LES and the esophagus seems possible and deserves further investigation.

Adult↗
PubMed1978

Hospitalized chronic alcoholic patients without field-dependent performance in the rod-and-frame test.

Hospitalized male chronic alcoholics (n = 60) fully employed and with no history of malnutrition were compared with matched nonalcoholic controls (n = 50) on the Rod-and-Frame Test (RFT). The RFT scores of the alcoholics were not significantly worse than those of the controls. This is in marked contrast to earlier reports of RFT field dependence in unemployed, indigent alcoholics and supports Burdick's findings with the Embedded Figures Test.

Adult↗
PubMed1976

[Corrective surgical procedures following partial gastrectomy for gastro-duodenal ulcer (authors transl)].

Corrective surgical procedures for postgastrectomy syndromes are well-established in abdominal surgery. The indications for early corrective intervention are clearly defined on the basis of the patients' postoperative course. Corrections at a later date should only be considered in presence of major symptoms which did not respond to conservative therapy and following careful morphological and functional assessment of the patient. An analysis of gastric acid secretion should be carried out before and after the operation. The aim of corrective interventions is the restitution, as far as possible, of physiological conditions: prevention of rapid gastric emptying and reduction of gastric hypersecretion. Through postoperative follow-up examination of the patients over many years is essential. The case history, operation technique and outcome is presented in this review of 92 patients treated at the First Department of Surgery, University of Vienna and the findings are discussed.

Adolescent↗
PubMed1976

[Evaluation of an experimental method for testing analgesic drugs by electrical stimulation of the skin (author's transl)].

The pain threshold and pain tolerance were determined by electrical stimulation of the skin employing a newly-developed apparatus. The efficacy of the method was evaluated in a double-blind cross-over study on ten healthy subjects with administration of 50 mg pentazocine plus 500 mg acetylsalicylic acid (P + A) orally in comparison with a placebo. The sensitivity of this method in determining the pain threshold was compared with a fixed intensity-variable time modification of the radiant heat method. The presence of sedative side effects of the drugs was tested by measurement of the reaction time to visual stimuli. All measurements were performed before and then 60 and 90 minutes after drug administration and an analysis of variance was carried out on the data. There was a significant elevation of both the pain threshold and pain tolerance as determined electrically after the administration of P + A as compared with the placebo experiments. A similar tendency was obtained with the thermal method, but the increase in pain threshold was not statistically significant. No significant changes were found in optical reaction time. It may be concluded that the apparatus developed by us appears to be a valuable tool in the evaluation of effectiveness of analgesic drugs.

Adult↗