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Biomedical subjects

H P Bruch

Publications and source records attributed to H P Bruch.

18 recordsLinked to original sources
PubMed1979

[Continent colostomy through free transplantation of autologous colon muscles].

The study is concerned with a problem which is to a great extent still surgically unsolved, namely that of the incontinent hollow organ occlusion. We report on our own experiments on animals and on physiologicofunctional studies, which reveal the suitability of the smooth muscles as an ideal material for sphincter replacements. By histologic research it became obvious that autotransplantations of smooth muscles, carried out for the first time by the Department of Surgery of the University of Würzburg, are possible without significant tissue changes. The transplant is soon supplied by vessels which sprout ubiquitously and completely permeate it so that it can take over its function as sphincter. Meanwhile, the experience gained in experiments on animals has been transferred to surgery on humans. Incontinence and incontinence of the preternatural anus were eliminated in the first operations using autologous autotransplanted sphincteroplasties.

Animals↗
PubMed1979

[Morphological findings on free intestinal muscle transplants as sphincter replacement].

Using autotransplants of an autonomous intestinal muscle segment a sphincter substitute and consequently a continent colostomy can be produced in humans and dogs. The histological study of the intestinal muscle section resected 1--28 weeks after implantation shows, in dogs, a good healing process and vascularization of the transplant muscle, which explains the clinical success. Even after many weeks only slight atrophy and fibrosis can be observed. Only a few of the intramural nerve plexuses perish. Some of the small intestine sphincters remain incontinent. The specimens show a more or less extensive hemorrhagic necrosis of the transplant with high inflammation. The reason for these complications is thought to be the mucosa glands, which were not completely removed from the vulnerable small intestine of the dog before the transplantation.

Animals↗
PubMed1978

Modulation of the prostaglandin-induced intestinal motility in humans through the transmitters of the vegetative nervous system.

Research was done on the reciprocity between adrenergic and cholinergic stimulating or inhibiting pharmaceuticals and the prostaglandin-induced intestinal motility. By cholinergic activation, the amplitudes of the prostaglandin-dependent rhythmical contractions of human taenia coli were intensified. There was very little influence on the frequency of contractions, however. Simultaneous stimulation of adrenergic beta-receptors by increasing doses of adrenaline or noradrenaline caused the contraction amplitude and frequency to decrease continually until the contractions were completely eliminated. The cholinergic effect could be suppressed with atropine, the adrenergic-stimulated reaction was reversed by the blockage of beta-receptors. It was completely abolished by simultaneous addition of alpha- and beta-receptor-blocking drugs.

Acetylcholine↗
PubMed1978

[Colon dynamics in ileus].

All forms of ileus have one thing in common, namely a disorder of the intestinal motility, which, with increasing distension of the intestinal wall, finally leads to paralysis of the intestine. With the increase in distension mechanical and functional colon changes take place which are discussed in this study. During peristalsis the strain on the wall is directed against the intra-luminal course of pressure. In spite of the increase of the internal pressure from 5 cm H2O to 100 cm H2O, the tension of the wall remains low or even decreases (roughly 500 dyn/mm2). In ileus patients, however, the strain on the intestinal wall increases enormously (about 100000 dyn/mm2). The maximum contraction capacity of the large intestine's muscle system (50,000 dyn/mm2) is high and similar to that of the skeletal muscles.

Colon↗
PubMed1978

[Impairment of adrenergic innervation in achalasia (author's transl)].

Length tension diagrams and diagrams of isometrically developed active tension were set up for normal and aganglionic cardia-circular muscles. The effects of acetylcholin, adrenergic stimulating and inhibiting drugs were examined. The physiological parameters in healthy cardia and the cardia muscle system in achalasia did not vary significantly from one another. The acetylcholin threshold was higher in aganglionic cardia, while the maximum effective dose in healthy and aganglionic cardia remained the same. In achalasia no sensitisation to acetylcholine was detectable. There was a marked impairment in the balance between adrenergic alpha- and beta-receptors, with the contraction-inducing alpha-receptors obviously predominating.

Acetylcholine↗
PubMed1978

The role of prostaglandines in peristalsis of the human colon.

Prostaglandines (PG) of the E and F series cause peristaltic activity in isolated longitudinal muscle strips of the human colon. As this phasic motor reaction can be varied by acetyl choline and adrenaline it was supposed, that prostaglandines contribute to peristalsis. The role of PG E and F in the human colon was studied by inhibiting the prostaglandine synthesis and by antagonizing the prostaglandine-effects. Indomethacin proved to be a suitable inhibitor. HR 546 was found a powerful antagonist. The effect of Pentagastrin and Cholecystokinin (CCK) on peristaltic activity were suppressed by Indomethacin and HR 546. The inhibition of peristalsis by Indomethacin and HR 546 was removed by high doses of PG E and F. On the basis of these results the role of PG for the motility of the gut is discussed.

Cholecystokinin↗
PubMed1977

[Adrenergic receptors in the pathogenesis of congenital megacolon (author's transl)].

Contractions of fresh specimens of taenial musculature from human colon were investigated under the influence of depolarization (bathing in solutions high in potassium), of acetylcholine, and of adrenaline; definite changes of contractile tension could be induced by these agents. The investigations were carried out using normal musculature as well as specimens from patients with congenital megacolon taken from the narrow segment. Contractions after depolarization and after cholinergic stimulation were equal in all specimens investigated, pre-extension of these specimens not differing significantly. Relaxation of colon musculature mediated by adrenergic receptors was very pronounced in normal musculature, but was lacking in specimens taken from the narrow segments of congenital megacolon. Sympathetic stimulation of normal taenial musculature does abolish completely cholinergically induced contractions. On the other hand, a preparation relaxed by adrenaline contracts very little after additional application of acetylcholine. These findings do suggest a severe disturbance of adrenergic receptors in the colon, or of adrenergic neuromuscular transmission in congenital megacolon.

Humans↗
PubMed1977

[Functional studies of the cardia muscles in achalasia].

1. The mechanical properties - extension behaviour and ability to contract per muscle cross-section - were the same for healthy and aganglionic cardiac sphincter. 2. The acetyl choline threshold is higher in aganglionic muscle strips. The maximum effective acetyl choline dose (2 microgram/ml) remained the same. 3. Achalasia is characterized by a considerable reduction of adrenergic beta-receptor activity and alpha-receptor predominance.

Acetylcholine↗
PubMed1977

[Possible significance of prostaglandins in the pathogenesis of Crohn's disease].

Prostaglandins (E1, E2, F2alpha) produce and intensify peristaltic contractions in the healthy human intestinal muscle system according to dosage (threshold I-10(-4) microng/ml--maximum effective concentration 1 microng/ml). By subsequent introduction of adrenaline, the intestinal muscle system activated by prostaglandines can be completely relaxed again. Intestinal muscles from patients with Crohn's disease show a marked deviation from this behaviour: 1. The intestinal muscle system is extremely sensitive to prostagladins: maximum concentrations are already reached by about a thousand times smaller concentration than in the intestines. 2. The dose of adrenaline does not lead to dialtion, which is usual, but to contraction of the muscle system. These changes in the contractility of the intestine can explain some components of the clinical symptomatology of Crohn's disease.

Crohn Disease↗
PubMed1976

[Contractility of the left ventricle in experimental septicemia].

In experimental septicemia a decrease of myocardial contractility could be demonstrated. Periodically a correlation between disturbance of contractility and endotoxinemia exists. Starting point of infection and type of bacteria were of no detectable influence. As far as the disturbance of contractility is concerned one must take into consideration the cardiotoxic effect of endotoxin, the influence of shock mediators, lacticemia as well as the decrease of coronary perfusion pressure.

Animals↗