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Biomedical subjects

M Starlinger

Publications and source records attributed to M Starlinger.

At least 91 records · Page 5Linked to original sources
PubMed1982

[The protective effect of systemic HCO3- administration on the gastric mucosa in shock].

Recent research has shown adequate mucosal blood flow and blood bicarbonate availability to be crucial in the prevention of gastric ulceration, yet the relative importance of these two factors is unknown. We studied the incidence of ulceration in rats subjected to hypovolaemic shock under varying conditions of blood flow and acid-base balance. At the start of the experiment 2 ml of 0.1 M HCl were instilled into the stomach. In the control series, severe systemic acidosis had developed after 2 hours of shock (mean arterial blood pressure 40 mm Hg) and 6 out of 6 stomachs were ulcerated. Mucosal blood flow, measured with radioactive microspheres, had drastically decreased. Prostacyclin, dissolved in 0.01 M phosphate, improved gastric blood flow, but did not help to correct acidosis, and 6 out of 8 stomachs were ulcerated. A higher degree of protection was observed when prostaglandin was dissolved in 0.16 M HCO-3. Intraarterial infusion of high concentrations of bicarbonate completely eliminated acidosis, with ulceration occurring in only 1 out of 6 rats infused with 0.5 M bicarbonate and in 1 out of 10 with 1 M bicarbonate. Blocking carbonic anhydrase with acetazolamide (100 mg/kg) completely prevented the protective effect of a 1 M HCO-3 infusion, and 6 out of 8 stomachs were ulcerated. Substituting TRIS buffer for bicarbonate in the infusion also eliminated acidosis, but neither concentrations of 1 M or 5 M buffer prevented the stomachs from ulceration (6 out of 6 with 1 M buffer and 5 out of 6 with 5 M buffer). We conclude that bicarbonate is the essential factor in prevention of ulceration in our shock model and that blood flow is also important as one component of a bicarbonate-dependent protection system involving carbonic anhydrase.

Acetazolamide↗
PubMed1982

[Current concepts in gastric ulcer pathogenesis (author's transl)].

Recent research has opened up new aspects in the pathogenesis of gastric ulcers. The central role of luminal acid remains unchallenged, although hypersecretion of acid is not necessarily a prerequisite factor in acute or chronic ulceration. A delicate balance is now known to exist between several protective mechanisms and this is essential in enabling the gastric mucosa to withstand the high H-ion gradient between lumen and surface cells. Apart from the role played by other protective mechanisms like mucosal permeability, alkaline secretion and secretory status, blood flow and intracellular buffering of influxing H+ seem to be the most important factors in maintaining the integrity of the gastric mucosa, because their absence always leads to ulceration. Chronic ulcer disease may, however, be dependent on a defect in the regeneration of the gastric mucosa, in addition to the lack of one or more protective mechanisms.

Bicarbonates↗
PubMed1982

Gentamycin-PMMA bead chains in the treatment of posttraumatic osseous and tissue infections.

Forty cases of posttraumatic osseous or soft tissue infections (34 : 6) which were treated by implantation of Gentamycin-PMMA bead chains are presented. Three patients died early during treatment. From the remaining 37 patients, 34 stayed free of relapse after the initial course of treatment, two suffered intercurrent relapse, but a second intervention proved to be successful. One patient still is not completely free of infection and the bead chains are still in place. The overall success rate seems to be in favor of this new form of treatment. The rationale and the advantages are discussed.

Adolescent↗
PubMed1981

The effect of hemorrhagic hypotension on urinary kallikrein excretion, renin activity, and renal cortical blood flow in the pig.

We measured urinary kallikrein by its esterolytic and kinin-forming activity in 5-minute urine samples obtained throughout continuous bleeding experiments in pigs to correlate possible changes in urinary kallikrein excretion during hemorrhagic hypotension with resin activity and renal cortical blood flow. Renin activity was determined in venous blood samples and renal cortical blood flow was estimated by the radiolabeled microsphere technique. The rate of urinary kallikrein excretion was increased about 4-fold within an arterial pressure range of 100-70 mm Hg, whereas below 70 mm Hg, arterial pressure urinary kallikrein activity declined to undetectable values. Renin activity was increased only 2-fold in the arterial pressure range between 100 and 70 mm Hg but was increased 4-fold at pressures below 70 mm Hg. The pressure range of 100 to 70 mm Hg corresponded to the autoregulation of renal cortical blood flow and glomerular filtration rate; below that pressure range, renal cortical blood flow dropped to about 10% of the initial value. Therefore, it seems that urinary kallikrein is activated mainly during the period of autoregulation, whereas renin activity is, in the main, increased below the autoregulatory range of pressure. The vasodilatory urinary kallikrein kinin system might be involved in maintaining sufficient local blood flow during autoregulation whereas a decrease in blood pressure below the autoregulatory range leads to a major increase in renin activity, thus illustrating the attempt of the organism to reestablish sufficient blood pressure to maintain autoregulation.

Animals↗
PubMed1981

The relative importance of HCO3- and blood flow in the protection of rat gastric mucosa during shock.

Recent research has shown adequate mucosal blood flow and blood bicarbonate availability to be crucial in the prevention of gastric ulceration, yet the relative importance of these two factors is unknown. We studied the incidence of ulceration in rats subjected to hypovolemic shock under varying conditions of blood flow and acid-base balance. At the start of the experiment 2 ml of 0.1 M HCl were instilled into the stomach. In the control series, severe systemic acidosis had developed after 2 h of shock (B.P. 40 mmHg) and 6 of 6 stomachs ulcerated. Mucosal blood flow, measured with radioactive microspheres, had drastically decreased. Prostacyclin dissolved in 0.01 M phosphate improved gastric blood flow but did not help to correct acidosis, and 6 of 8 stomachs ulcerated. A higher degree of protection was observed when the prostaglandin was dissolved in 0.16 M HCO3-. Intraarterial infusion of high concentrations of bicarbonate completely eliminated acidosis with ulceration occurring in 1 of 6 rats infused with 0.5 M and in 1 of 10 with 1 M bicarbonate. Blocking the carbonic anhydrase with acetazolamide (100 mg/kg) completely prevented the protective effect of a 1 M HCO3- infusion, and 6 out of 8 stomachs ulcerated. Substituting TRIS buffer for bicarbonate in the infusion also eliminated acidosis, but neither concentrations of 1 M or 5 M buffers prevented the stomachs from ulceration (6 out of 6 with 1 M buffer and 5 of 6 with 5 M buffer). We conclude that bicarbonate is the essential factor in prevention of ulceration in our shock model and that blood flow is also important as one component of a bicarbonate-dependent protection system involving carbonic anhydrase.

Acid-Base Equilibrium↗
PubMed1981

Failure of cimetidine to prevent gastroduodenal ulceration and bleeding after renal transplantation.

Treatment of renal transplant patients with the H2-antagonist cimetidine has previously been assumed to be of reasonable prophylactic value in controlling the incidence of the postoperative complications of gastric or duodenal ulceration. We attempted to evaluate the performance of the drug in a controlled trial by treating transplant patients with either cimetidine or a placebo. Of the 59 patients accepted for the trial, four had to be excluded eventually because of irregularities in the administration of the drug and, in on case, nonfatal respiratory failure. Six of 27 from the cimetidine group had erosions or ulcers by the third day after surgery and two more had them by the end of the fourth week. Three of 28 placebo patients developed lesions after 3 days and three more developed them after 7 weeks. In the months after transplantation, one cimetidine and two placebo patients developed ulcers. Bleeding occurred three times with cimetidine and twice with the placebo. Renal function was similar in both groups as was the necessity of transplantectomy because of irreversible rejection. We conclude that cimetidine does not lower the incidence of gastroduodenal mucosal lesions and upper gastrointestinal bleeding after renal transplantation, nor does it influence rejection of the allograft.

Adolescent↗
PubMed1981

H+ back diffusion stimulating gastric mucosal blood flow in the rabbit fundus.

The effect of barrier breakers on gastric mucosal blood flow (MBF) has been disputed, but the influence of acid back diffusion alone has never been studied. In anesthetized New Zealand white rabbits, intramural pH (pHi) and gastric MBF were measured with an antimony microelectrode and with radioactive microspheres (51Cr, 85Cr, 141Ce), respectively. Innervated fundic pouches were perfused with solutions of varying [H+] at 37 degrees C. In the rabbit, back flux of H+ is linearly dependent on luminal [H+] and in the present studies a direct positive linear correlation was found between luminal [H+] and MBF (r = 0.97 P < 0.001) while pHi remained unchanged up to luminal [H+] of 80 mM. The usual 80% increase in MBF induced by 80 mM HCl was prevented by pretreatment with vasopressin, which decreased pHi and caused gross ulceration. Without vasopressin, [H+] of 120 mM HCl produced gross mucosal ulceration and a decrease in MBF and pHi. Our data suggest that back diffusion of H+ influences MBF in the rabbit. There is an increasing MBF caused by increasing luminal [H+] up to 80 mM, beyond which MBF decreases. When the balance between back diffusion and MBF is disturbed by a vasoconstrictor or a high luminal [H+], pHi decreases and gross ulceration occurs.

Animals↗
PubMed1980

[The influence of prostacyclin on gastrointestinal blood flow during hypovolemic shock (author's transl)].

The influence of a continuous PGI 2 infusion on blood flow of various organs was tested in normovolemia and in hemorrhagic shock. PGI 2 increased the blood flow of stomach, pancreas and jejunum in normovolemic animals. The reduced blood flow due to hemorrhagic shock was increased to preshock values in stomach, pancreas, and jejunum. A linear correlation was found between the dose of PGI 2 and mucosal blood flow of the stomach.

Animals↗
PubMed1980

[Orthograde intestinal irrigation as a preoperative intestinal preparation. Reduction of the intestinal flora using antibiotics].

Whole gut irrigation is a now a well-established method of preoperative bowel preparation. Additional reduction of bacterial content is desirable. The influence of neomycin/bacitracin and clindamycin as well as the combination, as admixture to the whole gut irrigation, on the flora of the large intestine, was therefore investigated in a prospective controlled study. While neomycin/bacitracin caused only a reduction of aerobic, and clindamycin of the anaerobic bacteriae, the combination resulted in a nearly total eradication of detectable bacterial content at the time of operation.

Anti-Bacterial Agents↗
PubMed1979

Regional gastric mucosal blood flow in hypovolemic shock.

The effect of hypovolemia on the mucosal blood flow of the gastric corpus and antrum were tested with the microsphere method 30 and 60 min after induction of hemorrhagic shock in the rat. The results demonstrate a marked reduction after 30 and 60 min without any significant differences between the corpus and the antrum. This reduction is largely dependent on cardiac and circulatory function. It is concluded that the differences in energy metabolism, which have been implicated as explanation for the different susceptibility to develop stress lesions by Menguy and Masters, cannot be attributed tod different degrees of ischemia.

Animals↗
PubMed1979

[Pharmacological modification of regional blood flow in rat stomach mucosa].

The effect of three agents with antisecretory function on regional gastric mucosal blood flow was measured using the microspheres technique. Salbutamol caused a significant decrease in blood flow, while DMPGE2 caused a significant increase. After calcitonin no change was observed. This is contrary to the belief that inhibition of acid secretion is always associated with a decrease in gastric mucosal blood flow.

Albuterol↗
PubMed1979

[Regional gastric blood flow in hypovolemic shock in rats].

The effect of hypovolemia on the mucosal blood flow of gastric corpus and antrum were tested with the microspheres method 30 and 60 min after induction of shock in the rat. The results demonstrate a marked reduction after 30 min, with return to control values after 60 min, without any significant differences between corpus and antrum. It is concluded that the differences in energy metabolism between these two regions of gastric mucosa, cannot be attributed to different degrees of ischemia.

Animals↗
PubMed1978

[Whole gut irrigation for large bowel preparation (author's transl)].

In a controlled trial whole gut irrigation (w.g.i.) was compared with elemental diet for 4 days as large bowel preparation. Cleansing effect, caloric intake and preparation time were significantly better in the first group (w.g.i.). In addition w.g.i. was routinely used studying 42 patients in an open trial which showed also a reliable cleansing effect and good practicability. At present the experience refers to a total of 163 preparations by means of w.g.i. In a further study the efficacy of w.g.i. for removal of blood from the intestinal tract in patients with bleeding esophageal varices was investigated. In 8 out of 11 cases a complete removal of the blood masses was obtained, 3 of these patients showed an improvement of the preexisting coma-stage.

Aged↗
PubMed1978

Perforation of the oesophagus with an oblique--viewing endoscope in a patient with caustic stenosis.

A case of accidental oesophageal perforation during endoscopy in an elderly woman with acute alimentary obstruction of a caustic stenosis is presented. This demonstrates the risks in routine use of oblique-viewing endoscopes, especially in oesophageal exploration. The lesion was successfully treated by internal splinting with a Celestin tube. The indications for this kind of treatment arise in elderly patients with poor general condition in whom a preexisting stenosis guarantees the tight fitting of the tube.

Aged↗
PubMed1978

[Relevance of lower oesophageal sphincter manometry in prae- and postoperative evaluation of gastrooesophageal reflux disease (author's transl)].

In 27 patients with refluxoesophagitis the resting LES-pressure was approximatly 80% lower than in 12 patients with asymptomatic hiatal hernia and 15 controls. All patients in the first group were operated on and 21 fundoplications (Nissen) and 6 anterior plications (Dor) were performed. The postiperativ LES-pressures were 70% higher than praeoperative and almost identical for both methods. The effective restitution of a functional sphincter with these operations could be demonstrated in this way.

Adult↗
PubMed1978

[Should the B-I gastric resection no longer be used? Results of 228 cases (author's transl)].

Clinical indications, operative findings, technical details and pathological studies in 228 Billroth-I-Pean gastrict resections for gastric ulcer, are represented in detail. 186 of these patients could be followed up with a maximum of 18 years: 8.6% had troubles after meals, 8.6% gastritis of the remaining stump, 5.9% a small stomach syndrome and 0.5% a reflux oesophagitis. But no one of them had to be reoperated nor for functional troubles, nor for recurrent ulceration. According to the Visick classification the following results have been obtained: V. 1:75.3%, V. 2:13.4%, V. 3:7.5% and V.4:3.7%.

Disability Evaluation↗
PubMed1978

[Permeability of the gastric mucosa for carcinogens in taurocholate-induced injury of the mucosa barrier].

The influence of taurocholate-induced damage of the gastric mucosal barrier on transmucosal movement of methyl-N-nitro-N-nitrosoguanidine (MNNG) was investigated on dogs with Heidenhain pouches. We also investigated whether or not MNNG influences the mucosal barrier. The results of 10 experiments revealed no effect of MNNG on the mucosal barrier, but a significant time-related decrease of intraluminal MNNG concentration in the presence of taurocholate.

Animals↗