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Biomedical subjects

H J Klugmann

Publications and source records attributed to H J Klugmann.

14 recordsLinked to original sources
PubMed1990

[Individualized sulfasalazine treatment of ulcerative colitis and monitoring of patient compliance by determining sulfapyridine serum concentration].

Sulphasalazine (SASP) is the drug of choice in the treatment of ulcerative colitis (UC). But there are adverse effects in 20-30% dependent on the serum-level of the resorbed SASP-metabolite sulphapyridine (SP). Relapses during treatment may have their cause in an under-dosage or patient's non-compliance. In 19 patients with UC the possibility of an individualized most effective treatment and the patient's compliance by the simple practicable analysis of SP-serum-level were checked. The results show that it is necessary to dose the SASP in dependence of the genetically determined type of acetylation. The SASP-dosage must be decreased in patients with slow acetylation and vice versa consequently. After rectal SASP-application - in opposite to the oral treatment - significant lower serum levels of SP were analyzed. In 63.1% of the patients we found an insufficient of non-compliance.

Administration, Oral↗
PubMed1987

[The splendor and misery of Whipple's disease].

On the basis of two cases diagnosed by ourselves, and a review of literature the problematic Whipple's disease is demonstrated. The treatment of this rare disease is very successful but it is too seldom included in the differential diagnosis of arthralgia and malabsorption. Therefore fatal false diagnosis results very often.

Adult↗
PubMed1985

[Modified ALTAB test in the diagnosis of exocrine pancreatic insufficiency].

The indirect estimation of chymotrypsin by the tubeless ALTAB-test was performed in 17 patients with well-defined exocrine pancreatic insufficiency, 10 of them after operation for chronic pancreatitis. In comparison with 12 healthy subjects the test proved to be a non-expensive, certain and specific method for detection of moderate and severe exocrine insufficiency. It exists positive correlations with the secretin-pancreocymine-test and with the maximal stimulable secretion of insulin. Therefore the ALTAB-test after operations with modified anatomy of the gastro-intestinal tract especially is able to substitute extensive testing of secretion in screening and controlling of progression. The value of the 3-hour serum level of PABA corresponds to the urine output within 6 hours. There are such advantages like independence from the kidney-function, avoidance of incomplete urine-collection and a considerable reduced test-time too.

4-Aminobenzoic Acid↗
PubMed1981

[Endoscopic biopsy study results of stomach stumps following Billroth II resection].

The results of gastroscopico-bioptical examinations of 121 unselected patients on an average 18 years after the Billroth-II-resection on account of peptic ulcers were apart from 6 carcinomas (5%) conspicuously high incidences of polyps (17%), islets of lipids (13.2%) and dysplasias (19%). Manifold biopsies from anastomosis and middle of the stump showed an approximate histomorphological uniformity only in 50--60%, whereby atrophic changes at the anastomosis dominated in 29% of the cases. As in the non-operated stomach, therefore, also in the stump stomach the gastritic degrees of severity are unequally distributed. An atrophic gastritis was present altogether only in 50% of the patients so that postoperatively a regularly accelerated transition to the diffuse atrophy of the mucous membrane is not to be expected. The importance of the chronic atrophic gastritis with intestinal metaplasia as well as of the dysplasias--particularly in the Billroth II stump of the stomach--as a precancerous lesion or condition is discussed in connection with the increased risk of a carcinoma after resection of the stomach. Beginning with the 10th year after the Billroth-II-operation the dispensary care must be enlarged by long-term, continuous gastroscopico-bioptical controls, in which cases the early recognition of precanceroses and carcinomas is in the foreground.

Adult↗
PubMed1976

[Billroth II. Surgery of the stomach].

In different intervals 220 patients were examined after a resection of the stomach with Billroth's second operation. 179 of them spoke about complaints of different degrees of severity. The cases in question were an early dumping syndrome in 83 patients, which, with the exception of 7 patients, could be removed by simple dietetic measures, such as the elimination of incompatible foodstuff. Again and again the symptoms could be evoked by provocation with it. The method described by Henley proved as correcting operation. Apart from a few exception the fitness for work was not restricted by Billroth's second operation. In shift work or severe physical work a change of the working place was striven for. The body-weight which was reduced already before the operation again increased after operation in 50%, but reached the normal only in 20%. Recidivation ulcera and anastomositis of a suture were rare findings. Stump gastritis is no own clinical picture. Also in this case in histologically still normal mucous membrane earlier histochemical changes develop in the sense of a chronic gastritis with a reduction of the adenosin triphosphatase, the acid tissue phosphatase and succinodehydrogenase.

Adult↗