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Biomedical subjects

H Kasper

Publications and source records attributed to H Kasper.

At least 55 records · Page 3Linked to original sources
PubMed1989

Faecal short-chain fatty acids after colonic surgery.

Carbohydrates from dietary fibre and starch are broken down by the anaerobic microflora to short-chain fatty acids (SCFA) in the caecum and ascending colon. In this study the adaptation of the remaining distal colon or ileum to resection of various lengths of the proximal colon was investigated. Faecal SCFA concentrations (mumol/g wet weight) were measured after right hemicolectomy (n = 10), subtotal colectomy (n = 3) and total colectomy (n = 8) and compared with SCFA in control subjects (n = 21). After right hemicolectomy faecal SCFA (48.7 +/- 5.6) were not different from values obtained in control subjects (47.8 +/- 4.0). SCFA levels after subtotal colectomy (14.5 +/- 0.8) and total colectomy (6.7 +/- 1.4) were significantly lower than after right hemicolectomy and in controls. It is concluded that, after right hemicolectomy, the remaining left colon offers conditions favourable to bacterial fermentation. After subtotal or total colectomy, however, postoperative conditions do not allow a normal fermentative activity. The consequences of a reduced SCFA production for sodium and fluid absorption are discussed.

Adult↗
PubMed1988

Effect of starch malabsorption on colonic function and metabolism in humans.

To study the impact of starch on colonic function and metabolism, 12 healthy volunteers consumed a controlled diet rich in starch for two 4-wk periods. In one of the study periods they received the glucosidase inhibitor acarbose (BAY g 5421) and placebo in the other. Stool wet weight increased by 68%, stool dry weight by 57%, fecal water content by 73%, and the mean transit time by 30% on acarbose. Breath hydrogen was significantly higher on acarbose, indicating stimulated carbohydrate fermentation in the colon. Fecal bacterial mass (+78%), total stool nitrogen (+53%), bacterial nitrogen (+200%), and stool fat (+56%) were higher in the acarbose than in the control period. The stimulation of fermentation in the human large intestine may be important in colonic and possibly other diseases.

Acarbose↗
PubMed1988

Metabolic and nutritional parameters in patients after colonic polypectomy.

Breath methane and hydrogen, plasma acetate, serum selenium, vitamin A and beta-carotene were measured in 47 patients from whom colonic polyps had been removed by endoscopic polypectomy between 3 months and 2 years previously. Patients were compared with 39 control subjects in whom no abnormality was detected during colonoscopy. The proportion of methane exhalers was significantly (p less than 0.0005) higher in patients after polypectomy (66.0%) than in controls (28.2%). Mean plasma acetate was lower (p less than 0.025) in post-polypectomy patients (70.5 microM) than in control subjects (97.1 microM) while breath hydrogen was similar in both groups. The serum concentrations of the antioxidants selenium and beta-carotene showed no differences between the groups whereas vitamin A was higher (p less than 0.01) in serum samples of patients after polypectomy than of controls. These findings indicate that the colonic environment in post-polypectomy patients exhibits certain characteristics which may be related to the formation of benign tumors and possibly colon cancer.

Acetates↗
PubMed1988

The effect of starch malabsorption on fecal short-chain fatty acid excretion in man.

To study the impact of starch malabsorption on fecal short-chain fatty acid concentrations, 11 healthy volunteers consumed a controlled diet rich in starch for 2 4-week periods. They received the glucosidase inhibitor acarbose (Bay g 5421) in one of the study periods and placebo in the other. Stool wet weight increased by 68% and stool dry weight by 57% with acarbose. The fecal concentration (mumol/g wet weight) of n-butyrate (+58%) rose significantly when acarbose was added to the diet. The fecal excretion (mmol/day) of total short-chain fatty acids (+95%) and of their constituents acetate (+97%) and n-butyrate (+182%) was significantly higher when starch malabsorption was induced by acarbose.

Adult↗
PubMed1988

Effects of acetate during regular hemodialysis.

The utilization of acetate and its effects on acid-base balance and on free fatty acid metabolism were investigated during regular hemodialysis (HD). Fourteen patients with chronic renal failure were studied during two successive dialysis treatments for which either acetate or bicarbonate were used as a buffer anion in the dialysate. In the acetate studies the mean plasma acetate concentration in the arterial line rose from 0.16 mM to 4.67 mM, while it rose from 0.17 mM to 0.62 mM during bicarbonate dialysis. There was a linear relationship between acetate utilization and the acetate concentration in the venous line. The increase of the blood pH during bicarbonate HD was due to an immediate increase of HCO3, whereas acetate caused a smaller HCO3 rise and a pronounced fall of the pCO2. The heart rate was higher during acetate than during bicarbonate HD. During both types of dialysis there was a twofold rise of total FFA as well as the individual fatty acids palmitate, palmitoleate, oleate, stearate and linoleate which was of similar magnitude when acetate or bicarbonate were used. The postulated antilipolytic effect of the short-chain fatty acid acetate could not be demonstrated under the circumstances of routine hemodialysis. Pre-dialysis dopamine was elevated in 7 of the 11 patients and remained high during both types of HD; other hormones were normal during acetate and bicarbonate HD.

Acetates↗
PubMed1988

Systemic availability of propionate and acetate in liver cirrhosis.

In 15 patients with cirrhosis of the liver and 10 control subjects, 7.5 mmol sodium propionate and 7.5 mmol sodium acetate were instilled endoscopically into the duodenum. Venous concentrations of propionate and acetate were measured for 90 min after administration of the enteral dose by gas-liquid chromatography. In patients with liver cirrhosis, propionate rose from a basal value of 6.1 +/- 4.7 (SD) microM to a peak concentration of 50.1 +/- 25.6 microM, whereas, in controls, it rose only from 1.4 +/- 1.6 to 10.3 +/- 7.6 microM. The oral propionate clearance was significantly lower in patients with cirrhosis (4.51 +/- 1.63 L/min) than in controls (118.47 +/- 154.79 L/min). Acetate went up from 39.5 +/- 16.3 to 134.1 +/- 62.7 microM in patients with cirrhosis and from 60.9 +/- 19.0 to 102.0 +/- 44.0 microM in controls. The oral acetate clearance was lower in patients with liver cirrhosis (2.80 +/- 2.17 L/min) than in control persons (10.86 +2- 5.72 L/min). The differences between the groups were more striking for propionate than for acetate values. It is concluded that the systemic availability of propionate and acetate is higher in patients with liver cirrhosis than in controls. This may be due to portosystemic shunting and/or diminished hepatic and extrahepatic extraction of the acids.

Acetates↗
PubMed1986

Long-term treatment of acromegaly with the somatostatin analogue SMS 201-995 over 6 months.

This study examined the effects of the long-acting selective mini somatostatin analogue (SMS) 201-995 in two acromegalic patients who were treated for 3 and 6 months, respectively. During treatment the mean growth hormone levels (25.3 and 20.8 ng/ml vs 5.9 and 10.6 ng/ml) and somatomedin C levels (6.2 and 6.2 IU/ml vs 3.3 and 3.8 IU/ml) decreased and the patients reported an improvement in their symptoms. The main side effect was an increase in stool fat excretion which did exceed the normal range (less than 7 g/day) in one patient. Five acromegalics who received 2 X 50 micrograms SMS 201-995/day for 5 days showed a significant increase of stool fat excretion (1.7 vs 3.5 g/day; p less than 0.05). Fasting blood glucose levels, glucose tolerance, and glycosylated hemoglobin were not essentially effected. It is concluded that SMS 201-995 offers new possibilities in the treatment of acromegaly. The gastrointestinal and diabetogenic side effects of this substance, however, should be carefully monitored.

Acromegaly↗
PubMed1986

[Is there a diet therapy for malignant tumors].

None of the numerous und repeatedly recommended tumor diets' therapeutic effects have ever been proven. All types of diet are based on speculation. Starting points for a discussion on possible therapeutic mechanisms are the increased mineralocorticoid release as result of low sodium and high potassium uptake, the effects of a low fat intake on the immunological mechanisms, and the inhibitory effect on tumor growth by high carotene and vitamin C intake.

Dietary Carbohydrates↗
PubMed1985

Effect of Acarbose on the production of hydrogen and methane and on hormonal parameters in young adults under standardized low-fibre mixed diets.

Short and middle term effects of Acarbose were studied in volunteers on a standardized, low-fibre, mixed diet for the development of tolerance phenomena with gas exhalations and some peptide hormone levels as main parameters. Both hydrogen and methane were measured quantitatively as diurnal profiles. Acarbose caused an about 20-fold increase of H2 exhalation and had only moderate effects on methane production, indicating the presence of fermentable carbohydrates in the large bowel. Methanogenic individuals exhaled significantly less H2 than did non-methanogenic subjects. Changes in blood glucose, serum insulin, GIP, gastrin, and plasma glucagon, caused by Acarbose, reflected delayed glucose absorption and were plausible within the regulatory framework of carbohydrate assimilation. When the Acarbose regime was maintained for 5 weeks on a controlled diet, abdominal sensations like e.g. meteorism declined remarkably while carbohydrate fermentation remained high and lowered GIP was sustained. Thus functional responses of the gastro-intestinal tract to altered carbohydrate supplies, elicited by Acarbose, were found by 3 independent parameters: anaerobic gas production, peptide hormone levels, and subjective abdominal sensations. The objective parameters seem to remain constant in the longer run, while subjective parameters show long-term adaptation.

Acarbose↗
PubMed1985

Dose dependence of breath hydrogen and methane in healthy volunteers after ingestion of a commercial disaccharide mixture, Palatinit.

Breath hydrogen and methane were determined by gas chromatography in eleven normal individuals given a low-fibre, mixed diet (control) and after ingestion of 20-50 g Palatinit/d, an equimolar mixture of D-glucosyl-alpha(1----1)-D-mannitol and D-glucosyl-alpha(1----6)-D-glucitol (Isomalt). A linear relation was found (r 0.85; P less than 0.001) between the amount of Palatinit ingested and breath H2 per 10 h in subjects who did not exhale methane. If methane was formed in addition to H2, the sum of both gases followed a linear dose-effect relation. The mouth-to-caecum time, indicated by the first increase in breath H2 after ingestion, was shortened by about half, yet no sign of diarrhoea was observed. Stool weight and stool frequency did not change significantly. The linear relation between a dose of 20-50 g Palatinit and exhalation of H2 (eventually plus methane) indicated that a relatively constant fraction of the dose given underwent cleavage and absorption in the small intestine, the remainder being transported into the large bowel. Microbial gas formation in the colon as well as the fractional transfer of these gases into the expiratory air occurred at fixed proportions, thus allowing an insight into colonic microbial contributions to carbohydrate utilization in the human large bowel.

Adult↗
PubMed1985

European Cooperative Crohn's Disease Study (ECCDS): clinical features and natural history.

In the European Cooperative Crohn's Disease Study patients from 14 centers were included in whom diagnosis was made within 2 years before study entry on the basis of generally accepted radiological, endoscopical and/or histological criteria or a combination of all. Reasons for exclusion were: diagnosis older than 2 years in patients who did not require active treatment, age less than 18 years, duration of symptoms less than 3 months, presence of complications which potentially required emergency surgery. Data on clinical features were obtained in 633 patients, of whom 452 were eligible to participate in the study. In 110 patients randomized to placebo the natural course of Crohn's disease was studied. Patients with ileocolonic involvement were younger than patients with either colonic or small intestinal involvement only. Classic ileitis terminalis was present in 14% of the patients. 49% of the patients had combined involvement of both the small and large intestine. 30% of patients had only small intestinal involvement, and in 21% colonic disease was present. Small intestinal involvement was associated with a significantly lower Crohn's Disease Activity Index (CDAI) than other anatomical locations of the disease. Perianal disease was more often associated with colonic than with small intestinal involvement. 60% of placebo patients with active disease at entry achieved at least a transient remission within the initial 5 months of study. After 2 years, 23% of patients with active disease at entry and 68% of patients with quiescent disease had reached or maintained a remission, respectively. By stepwise multiple linear regression analysis long duration of disease between diagnosis and randomization, normal serum albumin and combined involvement of small intestine and colon were identified as predictors of a more favorable outcome of patients treated with placebo. In contrast, extensive small bowel disease, treatment with steroids and bowel resection prior to study entry correlated with a less favorable outcome. However, by life table analysis outcome of previously untreated and treated patients in the placebo group was similar.

Adrenal Cortex Hormones↗
PubMed1985

Output-dependent non-parallel enzyme secretion of the human pancreas.

In order to study the question as to whether the enzyme ratios in the pancreatic juice change with the secretion rate, we analysed the enzyme outputs of 20 healthy volunteers under combined stimulation with varying doses of cholecystokinin (0; 0.5; 1.0 or 1.3 IDU X kg-1 X h-1), administered in random order, plus a constant dose of secretin (0.5 CU X kg-1 X h-1). The outputs of the individual enzymes correlated significantly (p less than 0.0001) to the corresponding amylase outputs in the form of power model regressions. Mathematical transformation of these curvilinear regressions permitted a comparison of their courses. This analysis revealed that the enzyme ratios in the pancreatic secretion change continuously at increasing outputs in favour of lipase greater than chymotrypsin greater than amylase. The shift in the ratio of lipase to trypsin and to amylase and that of chymotrypsin to amylase was significant (p less than 0.01).

Adult↗
PubMed1985

The influence of dietary fiber on gastric transit time.

Little is known about the effect of dietary fiber on gastric emptying. At present, we do not know whether any therapeutic effects result from delayed gastric transit time. Functional scintigraphy was used to determine the effect of wheat bran, guar and pectin on the transit time of 200 ml fruit juice and 200 or 400 ml of a liquid test meal in normal healthy subjects. The transit time of fruit juice was significantly delayed by the addition of 4 g guar (viscosity 7079 mPA X s). Neither wheat bran, pectin nor guar resulted in a delay of the test meal transit time despite maximal increases in viscosity of up to 21,500 mPa X s. We therefore conclude that dietary fiber does not significantly delay the gastric transit time of test meals regardless of the increase in viscosity. The reduction in postprandial glucose levels after ingestion of guar or pectin is, therefore, probably not due to delayed gastric emptying.

Beverages↗