Search PubMed⌕ Search

Biomedical subjects

P Müller

Publications and source records attributed to P Müller.

At least 325 records · Page 18Linked to original sources

[4-way immunosuppression in pre-sensitized recipients of allogenic cadaver kidney transplants].

As a result of introduction of quadruple immunosuppression using cyclosporine, antithymocyte globulin, azathioprine and prednisone in immunological high-risk patients with a presensitization greater than or equal to 80% and/or multiple grafts the rate of immediate graft function could significantly increased, the frequency of rejection and graft rupture was reduced and the patient survival rate could improved to 100%. The problem of vascular rejection should resolved by a more aggressive biopsy approach.

Antilymphocyte Serum↗

[Stomach tolerance of buffered and unbuffered low-dose acetylsalicylic acid: an endoscopy controlled double-blind study in volunteers].

In this randomised double-blind cross-over study the gastroduodenal tolerability of buffered acetylsalicylic acid (ASS) (Aspalox = 325 mg ASS plus 300 mg magnesium aluminium hydroxide) daily has been compared with unbuffered ASS (325 mg) daily in 12 healthy volunteers using upper Gl-endoscopy. The treatment period lasted 14 days: endoscopic controls were performed at entry and repeated at day 14. At day 0 the mean endoscopic score averaged 0.8 +/- 0.1 in both groups (MW +/- SEM). One tablet Aspalox daily induced marked gastroduodenal damage at day 14 (6.5 +/- 1.5). The median lesion score rose from 1.0 (day 0) to 7.0 at day 14. Unbuffered ASS evoked almost identical gastroduodenal injuries at day 14 (7.5 +/- 1.8). The corresponding median values were 1.0 (day 0) and 7.0 at day 14. Our data suggest, that the amount of buffering in the Aspalox preparation is not sufficient enough to protect human gastroduodenal mucosa against low dose acetylsalicylic acid.

Adult↗

[Transplantation of the kidneys of donors with cancer--personal experiences and review of the literature].

From 1980 to 1988 more than 1,549 organ donors were harvested, 125 of them (8%) died from cancer--116 brain tumors and 9 donors with extracerebral cancer. In 3 donors suffering from extracerebral cancer 5 kidneys were transplanted. All transplants functioned well without tumor signs up to 21 months after grafting. However, because of tumor recurrence in nearly 50% of the cases described in the literature generally organs from donors suffering from extracerebral cancer should not transplanted if possible.

Brain Neoplasms↗

[Endoscopic studies on the gastric tolerance of paracetamol and acetylsalicylic acid. A placebo-controlled, double-blind study in healthy volunteers].

Endoscopic Studies on the Gastric Tolerance Following 6 Days Treatment of Paracetamol and Acetylsalicylic Acid/A placebo-controlled double-blind-study in healthy volunteers. In placebo-controlled randomized double-blind cross-over-fashion the gastric and duodenal tolerance of a 6 day treatment with 3000 mg acetylsalicylic acid (ASA; as a commercially available preparation) and 3000 mg paracetamol (Tylenol) were directly compared in 12 healthy volunteers. An endoscopic evaluation of the gastric and duodenal mucosa was performed. 3000 mg ASA daily evoked significant more gastro-duodenal lesions than 3000 mg paracetamol daily and placebo. Difference between Paracetamol and placebo did not reach statistical significance. Based on the comparable analgetic potency of both compounds and the apparently better gastro-duodenal tolerability paracetamol is the drug of choice when a non-inflammatory problem requires an analgesic.

Acetaminophen↗

[Value of bronchoalveolar lavage and findings of cytologic studies in the diagnosis of interstitial lung diseases].

In 27 patients with roentgenologically suspected interstitial pulmonary disease, bronchoscopy was carried out with the rigid bronchoscope. The examination material obtained (BAL fluid, transbronchial lung biopsy, perbronchial lymph node biopsy, mucosal biopsy) was submitted to a histological and cytological work-up. The established cell distribution in the BAL fluid confirmed the findings reported in the literature. In sarcoidosis, irrespective of the roentgenological stage, a 30 to 35% lymphocytosis was observed. The combination of BAL, perbronchial lymph node biopsy, transbronchial lung biopsy and bronchial mucosal biopsy permitted confirmation of the sarcoidosis in more than 90% of the cases. The -hit rate- of the perbronchial lymph node biopsy was 90.6% in stage 1, 85% in stage 2, and 77% in stage 3.

Asthma↗

[Lowering of the plasma lipid concentration with lovastatin. A clinical study in patients with primary hypercholesterolemia].

A study of 27 patients (18 males and 9 females; median age 57 [35-70] years) with hypercholesterolaemia examined the lipid-reducing effect, clinical reliability and tolerance of lovastatin, an HMG-CoA-reductase inhibitor, given in a single evening dose. After a four-week period on placebo and a lipid-reducing diet the patients received 20 mg lovastatin for four weeks. If, at the end of this period, total cholesterol levels were still above 200 mg/dl, the dose was increased to 40 mg, after a further four weeks to 80 mg. After a three-month treatment period total cholesterol concentration in lovastatin-treated patients was 28% lower than in the placebo group (289.4 +/- 42.2 vs 208.0 +/- 39.9 mg/dl; P less than 0.0001). LDL-cholesterol concentration had fallen by 40% (215.1 +/- 44.4 vs 130.1 +/- 24.7 mg/dl; P less than 0.0001), while plasma triglyceride concentrations had fallen by 15% (166.3 +/- 71.8 vs 141.8 +/- 69.8 mg/dl; P less than 0.01). At the same time, HDL-cholesterol levels had risen by 12% (42.9 +/- 12.4 vs 47.9 +/- 18.2 mg/dl; P less than 0.01). These results confirm the marked lipid-reducing effect of lovastatin.

Adult↗

[Treatment of non-steroidal anti-inflammatory drug-induced damage to gastric mucosa using ranitidine. Comparison of the effectiveness of 2 dosages].

339 patients with rheumatic diseases suffering from dyspepsia and endoscopically proven gastroduodenal lesion entered an open multicenter study with ranitidine 150 mg bid or ranitidine 300 mg administered at night in a single dose over 4 weeks. For entry the patients had to have been treated for at least 3 months with the non-steroidal anti-inflammatory drugs diclofenac, indomethacin and piroxicam. During the trial all patients were continued on NSAID. The data of 248 patients were evaluable. At entry, patients in both treatment groups had a total gastric damage score of 2.0. The duodenal lesion score was on average 1.43 in the ranitidine 150 mg bid group, and 1.8 in the 300 mg single dose ranitidine at night group. After 4 weeks of treatment the mean lesion score was significantly reduced in the stomach as well as in the duodenum with both ranitidine regimens, no differences being seen between the groups. In addition, rapid symptomatic relief was observed in both groups. After 4 weeks of treatment more than 80% of the patients were symptom-free or markedly improved.

Anti-Inflammatory Agents, Non-Steroidal↗

[Low T3 syndrome and chronic inflammatory rheumatism].

For the clarification of pathogenesis and clinical relevance of decreases of the triiodothyronine (T3) level in patients with chronic inflammatory rheumatism in a group of 63 patients with clinically, paraclinically and roentgenologically diagnosed rheumatoid arthritis (59 times) and with SLE (4 times), respectively, parallel were determined parameters of the thyroid gland function and of the rheumatic activity as well as a subtile drug anamnesis for the medication of antirheumatic drugs was established. In 33 of the 63 patients who were included into the study decreases and low normal values, respectively, for the total T3 (TT3 less than 1.5 nmol/l) were found. In comparison to the remaining 30 patients with normal TT3 a typical constellation of paraclinical parameters of the thyroid gland with distinct reduction of TT3 and free T3 (FT3), low normal total T4 (TT4), slight increase of the reverse T3 (rT3), moderate decrease of the basal and stimulated TSH and an only very small restriction of the binding capacity of the thyroid hormone (TBG) were found. A clinically relevant hypothyroidism is thus to be excluded with certainty. Antirheumatic drugs, in particular steroidal ones (glucocorticoids) may on principle also induce such paraclinical constellations, related to the thyroid gland. In our investigations a therapy with antirheumatic drugs is causally scarcely considered, since both in the group of patients with decrease of T3 and without decrease comparable quantities of antirheumatic drugs including glucocorticoids were administered and the cortisol values in the plasma do not differ. The investigations confirm our already formerly expressed supposition that also in rheumatics a "low-T3-syndrome" is existing as it is otherwise described in consumptive extrathyroidal diseases (NTI).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Ventricular late potentials in patients with cardiomyopathies in relation to electrophysiologic and myocardial biopsy findings].

With the noninvasive registration of late ventricular potentials there is the possibility to obtain statements about a regionally delayed excitation of ventricular parts which may refer to an increased inclination to ventricular tachyarrhythmias. Late ventricular potentials in patients with suspicion of primary diseases of the myocardium more frequently appeared both in the case of inducible non-sustained or sustained ventricular tachycardias and in the presence of simultaneous fibrous hypertrophy of the myocardium and interstitial fibrosis in the bioptate of the myocardium than in noninducibility of ventricular tachycardias and in the absence of histological changes of the myocardium. Thus in patients with cardiomyopathies a certain predicting significance seems to be ascribed to the evidence of late potentials in the highly increased signal-averaged ECG both for the ability to evoke ventricular tachycardias by programmed ventricular stimulation and for the presence of more distinct histological changes of the myocardium.

Adult↗

[Inhibition of 24-hour acidity by nizatidine].

In a randomized, double-blind, placebo-controlled, comparative cross-over study, we studied the effect of four H2-receptor antagonists on intragastric 24-hour acidity, nocturnal volume and acid output. Ten healthy male volunteers were administered 300 mg or 150 mg nizatidine, 800 mg cimetidine, 300 mg ranitidine, 40 mg famotidine, or placebo on several days, in each case at 9:000 PM. Nocturnal intragastric H+ concentration (mmol/l) (11:00 PM to 7:00 AM) was significantly reduced by all H2 blockers compared with placebo. We obtained the following inhibition rates: Cimetidine 67%; ranitidine 95%; famotidine 89%; nizatidine 80% (300 mg) and 69% (150 mg). Nocturnal acid (mmol/l) and volume output (ml/h) were also significantly (compared with placebo) inhibited by all four H2-receptor antagonists. Inhibition of nocturnal acid secretion was almost identical on nizatidine 300 mg nocte, ranitidine 300 mg nocte, famotidine 40 mg nocte, and cimetidine 800 mg nocte. Nizatidine 300 mg nocte and 150 mg nocte exclusively reduced acid secretion at night, without an aftereffect into the following day (8:00 AM to 6:00 PM). These results suggest that the clinical efficacy of these H2-receptor antagonists is identical with respect to healing peptic ulcer disease and providing freedom from pain. It is generally accepted today that gastric acid inhibitors used in the treatment of peptic ulcer disease should interfere with daytime gastric acid secretion as little as possible, particularly since the acid protects the stomach from bacteria ingested with the food during the day.

Cimetidine↗

Controlled trial of transdermal nicotine patch in tobacco withdrawal.

A transdermal nicotine patch, which delivers 0.7 mg/cm2 per 24 h and is available in sizes of 10, 20, and 30 cm2 was tested in subjects from 21 general medical practices in a 3-month, placebo-controlled randomised double-blind study. The nicotine group (n = 100) and the placebo group (n = 99) were similar at entry. Participants who smoked more than 20 cigarettes a day were treated with the 30 cm2 patch and the others with the 20 cm2 patch. When abstinence, defined as smoking 0-3 cigarettes per week and verified by CO measurement, was achieved, the next smallest patch was applied. After 1, 2, and 3 months of treatment 41, 36, and 36%, respectively, in the nicotine group were abstinent. The corresponding figures in the placebo group were 19, 20, and 23%. The differences were significant for all 3 months. Body weight did not increase in the nicotine group, but in the placebo group the mean increase was 4.4 kg. Craving and withdrawal symptoms decreased more with nicotine substitution for cigarettes. The patches were generally well tolerated, although 25% of subjects in the nicotine group and 13% in the placebo group had transient local erythema after application of the patch; 5 members of the nicotine group withdrew because of poor cutaneous tolerance.

Administration, Cutaneous↗

A possible role of plasma glutathione in glucose-mediated insulin secretion: in vitro and in vivo studies in rats.

In isolated rat pancreatic islets exogenous glutathione which is not able to penetrate into cells, augmented glucose (11.1 mmol/l)-mediated insulin release. In the presence of a non-stimulatory glucose concentration (2.8 mmol/l) glutathione had no effect. The half-maximal synergistic action of glutathione on insulin secretion was observed at approximately 8.0 mumol/l. This concentration of glutathione is similar to that found in the plasma of non-fasted anaesthetised rats (6.5 mumol/l). Oral ingestion of glucose increased the arterial plasma glutathione in rats. Our data provide for the first time indirect evidence for a modulating effect of plasma glutathione in postprandial glucose-mediated insulin secretion which appears to be located at the extracellular site of islet cells.

Animals↗

Comparison of the gastroduodenal tolerance of tenoxicam and diclofenac Na. A double-blind, endoscopically controlled study in healthy volunteers.

The gastroduodenal tolerance of Tenoxicam and Diclofenac Na has been evaluated in a double-blind, parallel group study in 36 healthy male volunteers. The doses used were 20 mg Tenoxicam and 100 mg Diclofenac Na daily in a retard formulation for 14 days. Gastric tolerance was assessed by endoscopy, which was performed at base-line, after the 14 day dosing period and after a 14 day follow-up period without treatment. The mucosal lesions were scored using modified Lanza criteria. Tenoxicam was significantly better tolerated at the end of the 14 day dosing period (mean gastric score: Tenoxicam 1.3; Diclofenac Na 2.2). The two treatment groups had comparable scores at the base-line and post study assessments. Tenoxicam and Diclofenac Na were generally well tolerated. Only two volunteers reported intermittant lack of appetite, heartburn and a feeling of pressure in the stomach.

Adolescent↗