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Biomedical subjects

U Gottstein

Publications and source records attributed to U Gottstein.

At least 19 recordsLinked to original sources

[Pathophysiology, clinical aspects and therapy of pre- and postoperative disorders of cerebral circulation and function].

The most important pathophysiological and pathogenetic facts are: The lower autoregulation threshold of cerebral blood flow and hypoxidosis, blood pressure in bradycardia, cerebral fits and stroke marks in CT, carotid atherosclerosis; reduced cerebral metabolism in chronic alcoholism and Wernicke. Reversible hypoglycemic induced hemiplegia. Multiinfarct syndrome and cerebral degenerative process Alzheimer. Effect of treatment by Piracetam.

Brain

Metabolic tolerance to high doses of oral xylitol in human volunteers not previously adapted to xylitol.

In a clinical study 12 healthy volunteers consumed a standardized basal diet consecutively supplemented with either sucrose (6 days, 80-100 g/day) or xylitol (18 days, 40-100 g/day). Pre- and post-periods with normal diet were also included in the study. With the exception of a few cases of diarrhoea at the start of the xylitol administration no other clinical signs indicated treatment-related side-effects. Whereas during the xylitol period plasma cholesterol values tended to be decreased, triglyceride levels remained unaffected. Other parameters (such as urinary calcium and oxalate as well as plasma uric acid) which have been suggested to be influenced by carbohydrate consumption were in fact not altered by the dietary regimen of the present study. A variety of other serum and urinary parameters revealed also no between-treatment differences. It may be concluded from these data under the present experimental conditions that subchronic consumption of considerable doses of sucrose and xylitol respectively reveals no relevant changes of a variety of clinical parameters which would indicate any kind of metabolic intolerance to these sweetening substances.

Adult

[Metabolic studies during the comparison of a reducing diet with standard nutriton in volunteers].

Using human volunteers the metabolic alterations during standardized nutrition (2,000 kcal/day = 8,400 kJ/day) and during energy-reduced nutrition (1,180 kcal/day = 6,000 kJ/day) with a carbohydrate-containing semiformula diet were investigated. Evaluating the concentrations of blood glucose, serum insulin and serum-free fatty acids it was demonstrated that the nutrition-induced metabolic alterations between the meals (i.e. hyperinsulinemia, low fatty acid concentrations) were not normalized in the group using the standardized diet. In contrast in the group with energy-reduced diet (240 kcal/meal = 1,000 kJ) the concentrations of serum-free fatty acids and of serum insulin reached the fasting values before the next meal. The concentrations of triglycerides and of urea show merely slight reactions following the meals. A rise in concentration of these two parameters is found after the last meal. It is concluded that with the standardized diet the absorption phase following the meals lasts for at least 4 h, whereas the absorption is ended within 2-3 h following the energy-reduced meal. The results of these investigations are interpreted as follows. During a carbohydrate-containing semiformula diet the metabolic mechanisms including the regulations remain unaltered. An effect of the energy reduction is found merely before the next meal. It is assumed that the semiformula diet used does not induce ketosis or glucose tolerance due to a sufficient supply of carbohydrates. With regards to the metabolic effects measured this kind of semiformula diet is judged to be well balanced.

Blood Glucose

[Effect of hyperventilation on cerebral blood flow and metabolism in man; continuous monitoring of arterio-cerebral venous glucose differences (author's transl)].

CBF decreases when arterial PCO2 is lowered by physiological, pathological or therapeutically induced hyperventilation. This is accompanied by an undelayed compensatory increase of oxygen-av-differences. Continuous monitoring of enzymatically determined glucose-av-differences of the brain during hyperventilation has for the first time shown that there is an undelayed fall of the cerebral venous glucose content, too. This indicates that the brain cells extract an augmented amount of glucose per ml blood during decreased CBF. Therefore glucose metabolism of the brain is not impaired during non-critical CBF reduction. However, when arterial PCO2 falls below 25 mmHg a detrimental effect on CBF and cerebral metabolism has to be expected. CBF will then decrease below the critical threshold for an undisturbed oxygen supply, and the respiratory alcalosis will lead to a disturbed oxygen delivery due to the Bohr-effect. As a consequence both of these factors will reduce the energy-yielding oxydative glycolysis and augment the little energy producing anaerobic glycolysis with a concomitant increase of lactate formation, resulting in a tissue and spinal fluid lactate acidosis. From our results it is therefore concluded that induced hyperventilation should be avoided, and that central hyperventilation in diseased states has to be considered as an additional threat to the brain.

Acidosis

[Treatment of acute cerebral ischaemia with low-molecular dextran: results of a retrospective study (author's transl)].

Between 1968 and 1970, 226 patients with acute cerebral ischaemia were treated with vasodilator drugs. In the subsequent three years (1971 to 1973) 202 patients were instead treated with dextran (Rheomacrodex) infusions. tin the latter period the death-rate was 35%, 19% less than during the preceding period of vasodilator treatment. In the dextran group among patients over 65 years the death-rate was 42%, 21% less than in the vasodilator group of the same age. Dextran treatment caused complete disappearance of neurological signs in 25%, compared with 7.5% in the vasodilator group. Dividing patients into those with normal blood pressure, hypertension and diabetes gave corresponding differences among the two groups. The death-rate during the period of dextran treatment was significantly less in all the sub-groups than in the vasodilator years. The results of this retrospective study provide important pointers to the effectiveness of dextran infusion in the treatment of acute cerebral ischaemia.

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