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Biomedical subjects

R Bittner

Publications and source records attributed to R Bittner.

At least 163 records · Page 9Linked to original sources
PubMed1981

[Plasma catecholamines, insulin and glucose in the postoperative phase. Cause and duration of the post-stress syndrome after abdominal surgery].

Plasma catecholamine, insulin secretion, and serum glucose levels were measured to determine the extent and duration of the postaggression syndrome following major abdominal surgery: 1. There was a significant increase in plasma catecholamine levels (epinephrine and norepinephrine) during the first postoperative week. -2. Glucose dependent insulin secretion remained elevated for more than 6 days following major abdominal surgery. -3. Postoperative glucose assimilation was reduced for more than 1 week. -4. There is a negative correlation between plasma catecholamine levels and reduced insulin secretion following the administration of glucose in the postoperative phase. -5. Inhibition of insulin secretion should be included in the therapeutic considerations for the first postoperative week in all patients undergoing major abdominal surgery.

Adult↗
PubMed1981

[Homeostasis of glucose and gastric resection. The influence of the food passage through the duodenum (author's transl)].

In 45 patients there was performed an oral glucose tolerance test after different types of gastric resection (Billroth I, Billroth II, total gastrectomy with a reconstitution with preservation of the food passage through the duodenum, total gastrectomy with exclusion of the duodenum). Additionally some patients with the same type of resection but with different types of stomach disease were investigated. The following results were achieved: 1. An increasingly reduction of the gastric remnant - 60% resection (B I), 75% resection (B II), total gastrectomy - leads after an oral glucose load to increasingly more rapid rise of blood glucose as well as to increasingly higher peak values of blood glucose concentration. 2. In patients with preserved food passage through the duodenum the oral glucose tolerance is significantly better and the secretory capacity of the beta-cells is significantly higher. 3. In spite of the same type of gastric resection patients with different types of stomach disease have as well as different patterns of oral glucose tolerance curve. Patients with Billroth II - gastric resection because of duodenal ulcer have significant more frequently a late postprandial hypoglycemia (without preceding hyperglycemia) than the patients with Billroth II because of ulcer/neoplasma ventriculi.

Adult↗
PubMed1981

[Endotoxins in bacterial peritonitis].

Tests for the presence of endotoxin in blood and peritoneal fluid were performed at short intervals in 19 patients with peritonitis, 9 following gastric perforation, and 10 with perforation of the large bowel. A highly sensitive precipitation technique (LAL test) was used. Endotoxin was demonstrated in peritoneal fluid during the early stage of peritonitis in 15 of 19 patients (79%), while blood determination revealed endotoxin in 7 of 19 cases within the first 48 h. During the clinical course circulating endotoxin was recovered in 12 of 19 patients, which implies endotoxinemia in 63% of the cases. The prognostic significance of endotoxin determinations was high, since circulating endotoxin was demonstrated within the first 72 h in 8 of 9 patients with a fatal course. Demonstration of circulating endotoxin is a time-consuming and complicated procedure with great clinical significance in patients with gram-negative peritonitis.

Adult↗
PubMed1980

[Insulin secretion after surgery: measurements after abdominal operations].

The study includes measurements of glucose and insulin in 30 patients after surgical trauma. The times of measurements were between the 2nd and 6th, 6th and 10th, and 10th and 21st postoperative days. An intravenous glucose load (1 g/kg body weight/60 min) was used. For the exact measurement of secretion of the islet cells we also determined insulin and glucose in portal venous blood. The following conclusions were made: (1) Measurements of insulin in the peripheral venous blood has no exact correlation to insulin secretion in the postoperative period. The insulin concentration in the portal vein blood after a glucose load shows significant variations to the insulin concentration in the cubital vein blood. (2) A greater surgical trauma (abdominal operation) causes a disorder of glucose utilization in the first postoperative week. (3) The insulin secretion after intravenous glucose load is significantly diminished during the first operative week.

Abdomen↗
PubMed1980

[The relationship between oral glucose tolerance and gastric emptying in duodenal ulcer patients (author's transl)].

In 50 patients with duodenal ulcer disease before the operation and early postoperatively after SPV there were performed simultaneously 54 measurements of halflife of gastric emptying (T 1/2) and of pattern of oral glucose tolerance curve. It could be shown that there is a close relationship between the type of disturbance of gastric emptying and the pattern of glucose curve. In addition it could be proved that there is a significant correlation between the T 1/2 and the 180-min.-glucose concentration.

Adult↗
PubMed1980

[Experiences with duodenum-sparing pancreas head resection in chronic pancreatitis].

1. A duodenum-preserved resection of the pancreas head was performed in 12 patients with chronic pancreatitis and tumor of the pancreas head without malignancy. The defect of the pancreas was repaired by an interposition of an jejunal 100p. -- 2. The clinical lethality was 0%. Follow-up after an average of three years showed 75% of the patients were completely able to return to work. -- 3. This resection procedure saves the patient from partial gastrectomy, common duct resection, and duodenectomy as compared to duodenopancreatectomy.

Adult↗
PubMed1979

[The significance of duodenal passage for insulin and gastrin secretion in patients following total gastrectomy].

After total gastrectomy and different forms of reconstruction as well as before and after B II-B I conversion, an oral glucose tolerance test was performed in 24 patients, and insulin and gastrin secretion were measured. The results in the patients with preserved or reestablished passage of the glucose through the duodenum demonstrate that (1) the glucose tolerance is significantly better, (2) the secretory capacity of the beta-cells is about twofold greater, and (3) the postprandial gastrin secretion is about threefold greater.

Adult↗
PubMed1979

[Postoperative disturbance in insulin secretion: studies on the altered secretion mode].

1. Depending on the operative trauma, insulin secretion is decreased until the 10th day after abdominal surgery. 2. The decreased insulin release is caused by a diminished discharge from the pancreatic beta cell during the second phase of insulin secretion (partially newly synthesized insulin). Insulin release during the early phase of insulin secretion (prestored insulin) is unchanged or even accelerated. 3. The glucose tolerance level is pathologically diminished until the 10th postoperative day.

Blood Glucose↗
PubMed1979

[Gastric motility after vagotomy (author's transl)].

1. Ulcer disease cause a change of gastric emptying; in patients with gastric ulcer gastric emptying of a semisolid meal is delayed as well as in patients with stenosis in the pyloricregion; patients with an uncomplicated duodenal ulceration shows an accelerated gastric emptying. 2. Vagotomy results in relation to the type of vagotomy and to the degree of desection of anteral muscles a delay of gastric emptying of a semi solid and liquid food until over the 6th postoperative month. 3. After selective proximal vagotomy (SPV) the gastric emptying is also but shortly delayed. 4. There is a correlation between the disturbed gastric emptying after vagotomy and the altered absorption of glucose.

Duodenal Ulcer↗
PubMed1978

[Surgery of gastric cancer in patients older than 70 years (author's transl)].

In this study it is reported about operative mortality and long-term results of surgery of gastric carcinoma in patients over the age of 70 years. The operative mortality in 50 patients with a distal partial gastrectomy was 16%, the mortality in 24 patients with total gastrectomy was 33.3% and in 14 patients with a proximal gastrectomy the mortality was 28%. The main cause of death (40%) was a pneumonia. There was no correlation between frequency of pneumonia and preoperative results of measurement of lung function. Only advanced arteriosclerotic disease in the heart and brain has a fatal influence on mortality rate. In the old patients the long-term results are determined by the staging of the tumor at the time of operation, too. In the 60 patients, who had left the hospital and who are in our control, the half year survival rate was 78.3%, the 1-year survival rate was 58.3% and the 2-years survival rate is exceeding 41.6%. 14 patients of the 17, who are still alive and who are after 2 1/2 years again explored, are in a very good condition. In comparison with the literature it is to conclude that for the indication to surgery of gastric carcinoma there is important not only the real age of the patient but rather the biological and mental condition of the patient.

Age Factors↗
PubMed1977

[Isolated stenoses and occlusion of the coeliac artery--a comparative angiographic and clinical study (author's transl)].

14 patients with occlusion (7 patients) or extreme stenosis (7 patients) of the arteria coeliaca underwent operation because of heavy abdominal complaints. The constriction of the arteria coeliaca was caused by arteriosclerosis (2 patients), ligamentum arcuatum medianum (8 patients), ligamentum arcuatum medianum and ganglion tissue (2 patients). For the restitution of a normal blood circulation in the epigastric organs the following was necessary: in 10 patients a decompression, in 3 patients an aortocoeliacal bypass and in 1 patients an enlargement plastic with vein patch. The angiographic findings indicate a connection between the arteria coeliaca occlusion or extreme stenosis and the extent of the collateral blood supply. High pressure gradients between aorta and arteria coeliaca, significantly decreased medium pressures in the arteria hepatica communis and noticably frequent morphologic changes in the epigastric organs could be seen intraoperatively.

Adult↗
PubMed1977

[Risk and postoperative complications in abdominal surgery in elderly patients (author;s transl)].

1005 case histories of patients, older than 70 years, were studied retrospectively: 496 abdominal interventions (lethality - 29%), 509 extraabdominal interventions (lethality - 14%). In each patient 75 preoperative data are compared to 50 data of the intraoperative and postoperative period. There is a correlation between preoperative findings and postoperative complications and lethality. The main factors of risk are: Hb less than 10 g%, Creatinine greater than 1,5 mg%. The analysis implies the necessity of intensive preoperative therapy as well as the immediate correction of even slight post-operative deviations of the "norm".

Abdomen↗
PubMed1976

Effects of selective gastric vagotomy and pyloroplasty on oral and intravenous glucose tolerance and insulin secretion.

In peripheral and portal venous blood, the immunoreactive insulin (IRI) and glucose levels in response to orally and intravenously administered glucose were measured in 14 patients with selective gastric vagotomy and pyloroplasty (SGV+P) and in 17 control subjects with other abdominal surgery. After intravenously administered glucose, the insulin and the glucose levels were nearly identical in both groups. After orally administered glucose, there were remarkable differences. Despite their early postoperative situations, and in contrast to the control patients, the SGV+P subjects showed no hyperglycemia. The measurements of IRI in the portal vein suggested that in SGV+P patients, the response of the islet cells is accelerated. In patients with SGV+P, the release of an insulinotropic intestinal factor and the preserved vagal innervation of the pancreas may be responsible for the accelerated insulin response of the undisturbed glucose tolerance.

Administration, Oral↗
PubMed1976

A novel nucleotide implicated in the response of E. coli to energy source downshift.

When E. coli cells are subjected to energy source downshift, the accumulation of RNA (and overall cell growth) is drastically restricted within 1 to 2 min. However, the identity of the primary metabolic signal for this adjustment is a mystery. Earlier studies, and further evidence presented here, show that there is no satisfactory correlation between the sudden adjustment of RNA accumulation and the kinetics of changes in the levels of prospective signalling compounds, such as glycolytic intermediates, ppGpp, ATP, or the three adenylate nucleotides. We have discovered an unusual nucleotide, which we call the phantom spot, whose level decreases dramatically within a minute of downshift, correlating well with the adjustment of RNA accumulation. Preliminary characterization of the phantom spot indicates that it is a triphosphate derived from the guanylate pathway, and suggests that it is a form of GTP with a modification of the imidazole portion of the purine ring. We postulate that this nucleotide serves as a regulatory facsimile of ATP, linking the rate of RNA accumulation and other anabolic processes to the overall rate of phosphorylation.

Adenosine Triphosphate↗