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Biomedical subjects

L Demling

Publications and source records attributed to L Demling.

At least 163 records · Page 9Linked to original sources
PubMed1976

[Effective treatment of duodenal ulcer with cimetidine (author's transl)].

Twelve male duodenal ulcer in-patients received in a double-blind trial either the histamine H2-receptor antagonist cimetidine (4 X 200 mg/d p.o.) or placebo capsules. Ulcer sizes were assessed endoscopically before therapy followed by repeat endoscopy at weekly intervals. Duodenal ulcer healing was significantly more rapid in cimetidine-treated patients than in those receiving the placebo (chi2 test; P less than 0.0005). Plotting of log ulcer sizes (mm2) against time (days) resulted in regression lines the slopes of which indicated the respective half-time of ulcer healing: about 6 days on cimetidine therapy and about 20 days on placebo treatment. Gastric secretion of acid, protein, pepsin, and N-acetylneuraminic acid-containing glycoproteins was not altered by a 4-week course of daily cimetidine or placebo, nor pancreatic secretion of bicarbonate and enzymes. No statistically significant changes in laboratory findings (haemoglobin, white blood-cells, neutrophils, platelets, alkaline phosphatase, blood-urea, serum-creatinine, GOT, GPT) were associated with treatment.

Adolescent↗
PubMed1976

[Clinical results of laser-coagulation in gastro-intestinal bleeding (author's transl)].

Endoscopic laser-coagulation was used 94 times in 14 patients to stop gastro-intestinal bleeding or coagulate potential bleeding sources during non-bleeding intervals. Lasting haemostasis was achieved in three cases of incomplete gastric erosion, one of gastric ulcer, one of duodenal ulcer and one of bleeding after antral rugectomy. It failed to stop severe arterial bleeding in a case of gastric carcinoma. Lasting haemostasis was achieved in six haemangiomas of the colon, one case of angiomatosis of the antrum with 62 individual sites, two of angiodysplasia of the colon, 17 lesions in Osler's disease of the oesophagus (2 cases), stomach (10) and duodenum (5). The procedure was performed in the course of diagnostic endoscopy with an argonion laser developed by the authors, which has a density of 0.7-1.3 W/mm2. No complications have been observed so far.

Argon↗
PubMed1976

[Folk medicine, experience therapy, a component of modern therapeutics?].

Empirical medicine has three main supporting pillars: physical treatment, dietetics and phytotherapy. In this area of medicine, a number of therapeutical methods have been evolved which stand up to investigations employing scientific criteria, and which, in consequence, have become officially recognized by medical science. Examples are: diet rich in bulkage, digitalis, products of Papaver somniferum (Poppy) and salicylates. The acceptance of phytotherapeutic agents into the drug armamentarium of scientific medicine presupposes the availability of test methods suitable to demonstrate their effectiveness. Quite a number of remedies that have always been firmly anchored in empirical medicine, but which was applied regularly only by the nature healer, have suddenly, in the light of new test methods, been shown to be effective medicines; thus, for example, onions and garlic are good for thrombotic processes and hyperglycaemia, carminatives for sphincter spasms in the gastrointestinal tract, and alcohol is an appetite-stimulating stomachic. This fact, the limited applicability of the information obtained from animal experiments, and the further fact that even test results obtained in human subjects cannot be applied on a world-wide basis, exhort us to take care not to subscribe to an all-too apodictic classification of therapeutic measures into effective and noneffective. A further point for consideration is that the administration even of what is only a supposed remedy, can trigger or promote healing simply on the strength of the action of the physician. Scientific thinking is an indispensible precondition of the physician's activity--to consider it as the beginning and end of all things medical, however, is simply to demonstrate a narrowness of outlook.

Asthma↗
PubMed1976

[Endoscopy, a hobby for specialists--or more?].

In the years between 1958 and 1970, diagnostic endoscopy made decisive advances. In this period, the ground was prepared for operative endoscopy. This applies not only to the technical, but also to the psychological aspects. The fact that formerly hidden structures could now be directly inspected and ""grasped'', spurned the endoscopist to intensive activity. Polypectomy, papillotomy with the removal of gallstones and, increasingly, photocoagulation for the arrest of bleeding, have made in many cases classical surgical operations superfluous. In close cooperation and rapport with the surgeons, the indications for, but also the limitations of, the new procedure are being established. In addition to the more practical aspects, modern endoscopy has also created a bridge to better understanding of biochemical processes in the gastrointestinal tract. The possibility of being able to investigate the effects of newly discovered, analysed and synthesized gastrointestinal hormones has been considerably improved. Endoscopy, formerly considered, more or less, a hobby for a few specialists, has become a sort of intermediary system which is capable of providing excellent diagnostic information, of making possible elegant therapeutic measures and of producing new biochemical information. In this creative function, it is surpassed by virtually no other method. A pre-condition for this development was, however, that the endoscopist was not content to remain merely an observer of interesting views, but was, rather, an active physician, to whom the advantages to the patient of early detection of disease and suitable therapeutic measures were equally important as the useful information obtained on biochemical relationships.

Cholelithiasis↗
PubMed1976

Release of motilin after duodenal acidification.

The physiological stimulus leading to motilin release in man has not yet been determined. Six healthy volunteers had 3-minute intraduodenal infusions of acid, alkali, or saline solutions. After infusing acid, plasma-motilin rose by 90% at 4 min and was still significantly raised at 45 min, whereas there was an insignificant fall in plasma-motilin after alkali and no change after saline solution. Release of motilin after duodenal acidification may be an important factor in inhibiting gastric emptying.

Adolescent↗
PubMed1976

[The value of the thermocouple in the measurement of the gastric mucosal blood-flow. The influence of the occlusion of the celiac artery and prostaglandin E1 on the gastric mucosal blood flow. An experimental study in animals (author's transl)].

The study has been carried out to ensure the positive evidence of the measurement of the gastric mucosal blood-flow with the aid of the thermocouple (heat-clearance technique). The experiments have shown that the suction pressure of 600 mm mercury column which was used to fix the Thermocouple to the mucosa was indispensable in order to assess the blood-flow in the entire depth of the mucosa. Changes in the mucosal blood-flow are measuured at the same rate in all quadrants of the gastric corpus. The measuring of the blood-flow of a well circumscribed area of the mucosa is therefore representative for the entire corpus. Vasopressin led to a significant reduction of the gastric mucosal blood-flow measured with heat-clearance as well aminopyrine-clearance. There was a linear correlation between the results of both methods. Vasopressin selectively reduces the blood-flow of the gastric mucosa but not of the submucosa, the muscular layer and the serosa. Therefore it seems to be probable that changes in mucosal blood-flow selectively can be measured with the aid of the thermocouple. After previous stimulation with pentagastrin neither mucosal blood-flow nor acid secretion of the stomach were influenced by the occlusion of the celiac artery by 25 %. The occlusion of the celiac artery by 50 % reduced significantly the pentagastrin-stimulated gastric mucosal blood-flow whereas the acid secretion was not influenced. Prostaglandin E1 at a dose rate of 2 mug/kg-h increased significantly arterial and mucosal blood-flow as well as acid secretion of the stomach. In comparison PGE1 administered at a dose rate of 4 mug/kg-h reduced significantly gastric mucosal blood-flow and gastric secretion. PGE1 at a dose rate of 8 mug/kg-h did not produce any significant changes in blood-flow and secretion. The results suggested that the changes of gastric secretion observed with PGE1 were the consequence of primary changes in the gastric mucosal blood-flow.

Animals↗
PubMed1976

Effects of 13-nle-motilin on salivary, gastric, and pancreatic secretions in man.

Salivary, gastric, and pancreatic secretory responses to intravenous 13-norleucine-motilin (13-nle-motilin), a synthetic analog of motilin and biologically equivalent to the natural polypeptide, were studied in healthy volunteers. 13-nle-Motilin in doses of 100 ng/kg body wt/hr significantly stimulated gastric pepsin output, while H + secretion and serum gastrin levels remained unchanged. Enhanced pepsin secretion was not accompanied by an increase in gastric secretion of cyclic 3', 5'-adenosine monophosphate, nor did gastric mucosal levels of the cyclic nucleotide rise. A dose of 13-nle-motilin, which stimulated gastric pepsin output, did not exert any significant effect on salivary and pancreatic secretions.

Adult↗
PubMed1976

Superior immunoreactivity of 125I (Des-Tyr-betaAla)-secretin with rabbit anti-secretin sera compared to 125I-secretin and 125 I-6-Tyrosyl secretin.

A secretin analogue in which the normal amino acid sequence had been elongated by a (Des-Tyr-betaAla)-residue was studied as tracer for secretin radioimmunoassay. 125I-(DATA)-secretin exhibited superior immunoreactivity with several rabbit anti-secretin sera compared to 125I-6-Tyr-secretin and also to secretin iodinated at its N-terminal histidyl residue. This may be due, at least in part, to higher conformational integrity of the secretin moiety in the 125I-(DATA)-secretin molecule. Thus, at present, 125I-(DATA)-secretin appears to be most suitable as tracer for sensitive secretin radioimmunoassay.

Amino Acid Sequence↗
PubMed1976

[The function of the hydrokinetic and ekbolic pancreas after acute pancreatitis].

Thirteen patients were investigated 3-4 weeks (I. examination) and 3-5 months (II. examination) after the ceasing of the signs symptoms of an acute pancreatitis concerning their hydrokinetic and ekbolic pancreas-functions. In addition, the pancreatic ducts were demonstrated by ERCP. Reduction of the secretion were shown in 31% at the I. examination and in 23% at the II. examination. There were significant differences in the outputs of bicarbonate, trypsine and chymotrypsine compared to healthy test persons at the I. examination. At the II. examination, however, no significant differences could be observed compared to healthy test persons. The exocrine function of the pancreas was getting worse during the interval between the I. and II. examination in 2 cases but it became normal in 5 cases. Pathological alterations at the pancreativ-duct-system were not demonstrable shown at all.

Acute Disease↗
PubMed1976

Motilin-induced electrical activity in the canine gastrointestinal tract.

Myoelectric activity induced by a synthetic analogue of the duodenal polypeptide motilin, was studied in isolated vascular-perfused canine duodenum and stomach, and in conscious dogs with serosal electrodes implanted in the stomach and the small intestine. In the isolated preparation, the duodenum was found to be four times as sensitive as the antrum to the polypeptide, showing a dose-dependent increase in spike activity within two minutes after administration of the polypeptide. By contrast, in the conscious fasted animal, the only response to motilin, above a threshold dose, was the interpolation of a premature migrating myoelectric complex in the spontaneous interdigestive sequence, appearing fifteen to twenty minutes after the start of infusion. Since the essential difference between the ex vivo and the intact intestine was the preservation of efferent and afferent nervous connections in the latter, it seems that in the conscious animal, the response to exogenous motilin is modulated by the innervation of the intestine, or, alternatively, motilin interacts with the centre controlling the pattern of motor activity in the small intestine rather than directly with smooth muscle. The latter hypothesis is supported by the observation that motilin had no effect on the motor activity of the small intestine during the infusion of pentagastrin which abolishes spontaneous migrating myoelectric complexes.

Action Potentials↗
PubMed1976

Potentiation between 13-Nle-motilin and acetylcholine on rabbit pyloric muscle in vitro.

The interaction of 13-nle-motilin-a synthetic analogue of the natural polypeptide-with acetylcholine was studied on rabbit isolated pyloric sphincter in vitro. Adding subthreshold doses of 13-nle-motilin reduced the calculated acetylcholine dose for half maximal contraction from 3.68 to 1.33 X 10(-6) g/ml and increased the calculated maximal response by 15.3%. Thus 13-nle-motilin caused potentiation of the acetylcholine response. Since 13-nle-motilin induced increase of endogenous acetylcholine levels could be excluded, a direct action of motilin on or in the smooth muscle cell is suggested. The results are compatible with the view that in vivo subthreshold doses of motilin may affect cholinergic driven pyloric motor activity.

Acetylcholine↗
PubMed1976

Release of motilin in man.

The effects on motilin release of various stimuli including an ordinary hospital lunch and ingestion of equicaloric amounts of protein (steamed cod), fat (double cream), or carbohydrate (glucose solution), and intraduodenal instillation of acid (0.1M HCl) and alkali (0.3M tris buffer, pH 10.2) have been investigated in healthy volunteers. Duodenal acidification resulted in a 90% rise of plasma motilin while after intraduodenal instillation of alkali motilin fell. No significant change was seen after a normal hospital lunch and the protein meal, and a small fall was observed after glucose. By contrast, after ingestion of 60 g fat motilin showed a peak increase of 65% at 30 minutes and was still significantly elevated at 60 minutes. Exogenous motilin has been reported to delay gastric emptying and this is also seen after duodenal acidification and fat ingestion. We conclude that motilin may be released physiologically by these stimuli and mediate their effects on gastric emptying in man.

Adult↗
PubMed1976

Intravenous 13-Nle-motilin increases the human lower esophageal sphincter pressure.

UNLABELLED: To elucidate whether, in principle, motilin could serve a role in LESP regulation, the effects of 13-norleucine-motilin (13-nle-m)-synthetic analogue of motilin and biologically just as active as the natural polypeptide-on LESP were investigated in normal subjects. LESP was monitored with the continual withdrawal method. Sets of tests: (1) i.v. pulse doses of 13-nle-m (0.05, 0.1, 0.2, and 0.4 mug/kg) were given to 6 subjects in random order on different days, (2) i.v. bolus injections of 0.6 mug/kg pentagastrin were given to elicit maximal LES contractions, (3) i.v. infusions of 13-nle-m (0.1, 0.2, and 0.4 mug/kg-h; doses doubling every 30 min) were used in 7 individuals, and (4) the effect of atropine infusion of 13-nle-m-stimulated LESP was studied in 6 subjects. RESULTS: (1) Graded i.v. pulse doses of 13-nle-m caused LESP to increase dose-dependently with maximum pressures exceeding basal levels by about 160% (p less than 0.01). After each bolus injection, peak values were achieved within 1-2 min followed by a steady decrease in LESP. (2) Maximum response to 0.4 mug/kg 13-nle-m was about 65% of that to 0.6 mug/kg pentagastrin. (3) i.v. infusions of varying doses of 13-nle-m caused a significant and dose-dependent increase in average LESP. (4) The stimulating effect of an i.v. pulse dose of 0.1 mug/kg 13-nle-m on LESP could be suppressed by concomitant atropine. CONCLUSION: the human LES is responsive, indeed, to exogenous motilin.

Adult↗