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Biomedical subjects

K U Schentke

Publications and source records attributed to K U Schentke.

At least 19 recordsLinked to original sources
PubMed1991

[The effect of various non-ulcer pharmaceuticals on nocturnal gastric pH in healthy subjects].

The effects of 4 non-ulcer drugs and the M1-antagonist pirenzepine on the nocturnal intragastric pH were investigated in 12 healthy volunteers. We tested single doses of pirenzepine (100 mg), Chlorprothixene (30 mg), clonidine (75 micrograms), ketotifen (3 mg) and nifedipine (30 mg) in an randomized, single-blind, cross-over study. The nocturnal intraluminal pH is significantly elevated not only by pirenzepine but also by the other substances. As expected pirenzepine (mean nocturnal pH = 2.49 +/- 0.22) shows the most distinct effect, nifedipine (mean nocturnal pH = 1.72 +/- 0.20) the most sparsely effect. The other drugs are nearly half as effective as pirenzepine. The acid suppressive side effect of the non-ulcer remedies is considered to be important for the treatment of ulcer patients with concomitant diseases.

Adult↗
PubMed1991

[Ultrasonography studies on spontaneous and pharmacologically modified gallbladder motility].

The intra- and interindividual variations of gallbladder motility were sonographically studied in 10 healthy subjects. We investigated the following criteria: a) the gallbladder volumes after overnight fasting on 5 consecutive days, b) the spontaneous motility under fasting over 12 or 24h at hourly intervals, c) the emptying rate and time of maximal contraction after stimulation with sorbitol, and d) the emptying rate and time (like c) after premedication with "cholagogic" drugs (Cholecysmon, Divalol), nifedipine, indomethacin or N-butylscopolaminiumbromide. We found a great intrapersonal and interpersonal variability in gallbladder volumes after overnight fasting in consecutive days. In subjects fasting over 24h phases of dilatation with maxima at 12 AM and 4 PM alternated with phases of contraction with maxima at 8 AM and 4 PM. After premedication with nifedipine, indomethacin and N-butylscopolaminiumbromide a significant decrease of the emptying rate was observed. The time of maximal contraction did not differ however. After premedication we found a distinct intra- and interindividual variability too. Cautious interpretation of gallbladder motility studies is necessary.

Adult↗
PubMed1991

[Lipid metabolism disorders in primary biliary cirrhosis (PBC)].

40 women, average age 52.5 years, with varying stages of primary biliary cirrhosis, were observed. One third of them suffered from a mild anaemia, mean plasma concentrations of ALAT were increased four times and those of AP six times. Despite the hepatocellular damage products of the liver synthesis such as transport proteins or coagulation factors were found to be normal or enhanced. 60% of the patients had a hypercholesterolaemia. The risk factors low density lipoprotein (LDL)- and very low density lipoprotein (VLDL)-cholesterol showed normal levels, but the protective factor high density lipoprotein (HDL)-cholesterol was clearly increased. Apart from the low blood pressure in most of the patients and the absence of other risk factors these observations explain, why patients with PBC and hypercholesterolaemia don't usually develop arteriosclerotic complications. Only in case of severe cholestasis a lipid constellation comes into being accompanied by high risk for the blood vessels, but in these cases the terminal stage of PBC limits the survival. Positive correlations between markers of cholestasis and lipid parameters let an enhanced production and simultaneous impaired excretion of cholesterol be assumed.

Adult↗
PubMed1991

[The significance of internal medicine intensive care within the complex of intensive medicine. Discussion contribution to the structural and professional classification in adult intensive medicine].

The development and establishment of intensive care units for adult patients requires a far-reaching subdivision into surgical and conservatively oriented intensive care for qualitative and quantitative reasons. Insufficiently substantiated claims to monopolization of intensive care techniques that are polemically asserted have to be strongly contradicted. The present paper is concerned with approved structural concepts of intensive care developed by Deutsche Krankenhausgesellschaft and various medical societies. They are supplemented by personal experience in the field of internal intensive care.

Adult↗
PubMed1990

Prophylactic endoscopic sclerotherapy of esophageal varices--a prospective randomized trial.

Sixty-three patients with degree III or IV esophageal varices and the so-called red color sign, but without previous bleeding were randomly assigned to either prophylactic sclerotherapy (PST) (n = 30) or to a control group (n = 33). In 58 cases the portal hypertension was caused by liver cirrhosis (40% alcoholics). The two groups were comparable with respect to demographic data and endoscopic appearance, causes and severity of liver damage. Sclerotherapy was performed as combined intra-and paravariceal injections of 2 or 3% polidocanol. All patients, both in the treatment and in the control groups, who bled from varices after randomization, received sclerotherapy until the varices were eradicated, and remained in their groups. After a mean follow-up of 44.5 months, the bleeding rate in the PST group was significantly lower (30% vs 75%, p less than 0.01). The difference became significant from the second year onward. Fourteen patients of the PST group and 19 of the controls died (4 and 14, respectively, p less than 0.05 as a result of the bleeding). Life table analysis (Kaplan-Meier) revealed no differences in survival between the two groups. At the present time PST cannot yet be recommended as a method for clinical routine use.

Adult↗
PubMed1990

[Drug-induced liver damage from the clinical viewpoint].

Extensive drug-induced hepatic injury leading up to jaundice occurs relatively rarely. Generally it is not predictable, independent on dosage and irreproductible in animals. As a rule you find it in less than 0.1% of the patients taking the drug, whereas the degree may range up to heavy or lethal (e.g. for isoniazid, methyldopa, halothane). Pathogenetically reactive metabolites capable of producing cytotoxic and/or immune reactions may play a role. Obviously higher age, female sex and endogenous or exogenous alterations in hepatocellular drug metabolism are disposing factors. Drugs, to which our patients most frequently reacted, were dihydralazine alone or in combination with propranolol, and ketophenylbutazone. The lymphocyte transformation test proved diagnostically valuable although it cannot be considered to represent a generally reliable testing method for drug-induced liver disease. Clinical, laboratory and histological findings are typical with a wider range of drugs, but liver biopsy provides the most reliable criteria. Clinical suspicion and stopping the intake of potentially noxious drugs are of importance. The reexposition test should be reserved to exceptional cases.

Chemical and Drug Induced Liver Injury↗
PubMed1989

[Regression of stomach polyps--spontaneous or induced?].

In an endoscopic follow-up study of gastric polyps we examined their spontaneous disappearance, and the reaction of the rest of polyps after polypectomy. We found spontaneous disappearance in 28 (12.4%) out of 226 patients with gastric polyps. 19 patients showed complete absence of polyps in the later follow-up. Spontaneous disappearance was found in a great number of cases without biopsy of the polyps themselves (16 patients). In the cases of known histology there were predominantly inflammatory, benign polyps (16 out of 18 patients). From among 206 endoscopic polypectomies evident residual tissue was left behind in 19 (9.2%) cases. However, only one premalignant and one malignant residual part of polyp could be diagnosed. In the case of malignant degeneration (early cancer) there was successful treatment by means of 4/5 gastric resection.

Biopsy↗
PubMed1989

[A high rate of surgery of stomach ulcer in long-term follow-up].

In 1983, 685 out of 1,284 patients having suffered from a gastroscopically identified gastric ulcer in the period from 1972 to 1980 answered a questionnaire. Males prevailed in a proportion of 1,7:1. They showed an earlier onset of the disease and a higher operational rate. As much as 44.2% of them reported complications (mostly haemorrhage), 44.8% a gastric operation. A review of the operation reports showed an incidence of 1% of gastric carcinoma 1-3 years after gastroscopy. In order to demonstrate a better prognosis of gastric ulcer non-selected prospective long-term studies should be performed.

Adult↗
PubMed1987

[Endoscopic sclerotherapy of esophageal varices--studies of the technic and follow-up].

Several prospective studies on the efficiency and technique of endoscopic sclerotherapy (EST) were performed among 300 patients with bleeding esophageal varices, 173 of which had been treated by EST. Contrasted with a comparable control group (n = 80), EST (n = 100) reduced the incidence of rebleedings (40% vs 13.3%; p less than 0.0005) and the lethality (46.7% vs 30.6%; p less than 0.05) during the observation period of 21 months. The paravariceal and the intravariceal injection techniques were compared in 20 patients each. A higher number of initial and repeated treatment sessions argued against the paravaricel technique (mean follow up: 4 years). In a randomized study on prophylactic EST we found a lower bleeding frequency (13% vs 39%) in 16 patients treated by EST compared to 18 controls.

Esophageal and Gastric Varices↗
PubMed1986

[The development of endoscopic papillotomy in East Germany].

UNLABELLED: Up to the middle of 1985 a survey of endoscopic papillotomy (EPT) had been carried out in the GDR resulting in 3124 patients from 8 centers. INDICATIONS: choledocholithiasis 90.6% (13.1% with a T-drain, 16.2% with a gallbladder in situ); papillary stenosis 4.4%; tumors of the papilla 2.2%; other indications 2.2%. The common bile duct got free of stones in 89.3% of 2210 documented cases after successful EPT. In comparison to former results in 1982, 1983 and 1984 (cumulated data) the technical success rate of EPT rose slightly, but steadily to 95.3%, and the complication rate fell to 5.8%. Bleeding was the most common complication followed by cholangitis, pancreatitis, basket impaction and perforation. 30 patients (0.96%) died due to complications, 14 with pancreatitis, 7 cholangitis, 7 bleeding, 2 perforation.

Ampulla of Vater↗