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Biomedical subjects

Z Tulassay

Publications and source records attributed to Z Tulassay.

At least 109 records · Page 6Linked to original sources
PubMed1990

[The effect of somatostatin in dumping syndrome].

The effect of cyclic somatostatin on early and late dumping syndrome was studied in 12 patients with gastric resection. Each patient underwent two glucose challenges with 75 grams of glucose administered orally. In the control study isotonic sodium chloride was given, while in the other study cyclic somatostatin in a dose of 250 micrograms bolus injection followed by infusion of 80 ng/kg/min for a period of 270 minutes. In the control study all patients showed subjective symptoms of the early dumping syndrome with significant increases in pulse rate, hematocrit, and vasoactive intestinal polypeptide. Ten patients showed asymptomatic hypoglycemia, as a sign of the late dumping syndrome associated with a significant increases of insulin, gastric inhibitory peptide and glucagon levels. During the administration of somatostatin these changes failed to develop. These results indicate that somatostatin alleviates the symptoms of early and late postprandial dumping syndrome.

Dumping Syndrome↗
PubMed1990

[Atrial natriuretic peptide in dumping syndrome].

The significance of atrial natriuretic factor (ANF) was investigated in the maintenance of the fluid volume in hypovolemia associated with dumping syndrome following gastric resection. The study was performed on 10 patients with Billroth II procedure. Ten age and sex matched patients--without previous gastric surgery served as controls. Each patient underwent oral glucose challenge. The patients following gastric resection underwent an other glucose challenge with intravenous infusion for the maintenance of the fluid volume. All patients with gastric resection showed subjective symptoms of the early dumping syndrome with significant (p less than 0.001) increases in heart rate and in hematocrit, while plasma ANF level decreased significantly (p less than 0.01). Significant negative correlation was found between the changes in hematocrit and the changes in plasma ANF level (r = -0.89; p less than 0.001). Neither the subjective symptoms characteristic for early dumping syndrome, nor changes in the laboratory parameters were noted in the patients during the challenge with infusion. The results show that the hypovolemia in dumping syndrome is associated with significant decreased ANF activity, and in the regulation of ANF release besides the well known stimulating effect of hypervolemia, there exists an inhibition of secretion in volume depleted states.

Atrial Natriuretic Factor↗
PubMed1990

[Secretin versus cimetidine in the therapy of active bleeding from peptic gastroduodenal lesions. A prospective, randomized, double-blind, multicentric study].

In a multicentric, prospective, double-blind, randomized trial 101 patients with active bleeding (Forrest, Type 1/b) from gastroduodenal ulcers or erosions were treated with secretin (n = 50, dose: 800 clinic units/24 hours) or cimetidine (n = 51, dose: 75 mg/hour). The bleeding and the effect of the therapy were endoscopically confirmed. The bleeding was stopped during 48 hours of treatment in 36 patients of the secretin treated group and in 25 of the cimetidine treated group (p less than 0.05). In 72 hours the control of bleeding was established in a total of 75 patients (41 secretin, 34 cimetidine; not significant). Surgery was necessary in 7 vs. 9 cases. The mortality was 1 vs. 4 cases. The mean transfusion requirements were 6.6 units in secretin- and 8.2 units in cimetidine treated group (p less than 0.01). There was no difference in rebleeding rate. The results show a trend in favour of secretin compared to cimetidine in the treatment of active bleeding from gastroduodenal ulcers or erosions.

Adolescent↗
PubMed1990

Atrial natriuretic peptide in patients with decompensated hepatic cirrhosis.

Plasma concentrations of atrial natriuretic peptide (ANP), aldosterone (PA), vasopressin (AVP) and plasma renin activity (PRA) were measured in 15 patients with decompensated cirrhosis of the liver during a control period and subsequently during intravenous administration of albumin. Infusion of hyperoncotic albumin increased diuresis, natriuresis, stimulated ANP secretion and tended to normalize other vasoactive hormone levels in 9 patients (responders), whereas it had no effect in 6 other patients (non-responders). Responders had significantly lower basal levels of ANP and higher ones of PRA, and AVP than non-responders, suggesting that responders had decreased effective intravascular volume. Our data suggest that cirrhotic patients with ascites formation do not represent a homogenous group. In some patients with decompensated cirrhosis a compromised circulatory state with decreased effective circulatory volume induces compensatory changes in several regulatory hormones. It appears that secondary alterations in the plasma concentrations of ANP of cirrhotic patients may occur according to the suspected change of intravascular fluid volume.

Aged↗
PubMed1990

[Endoscopic treatment of acute biliary pancreatitis].

The authors examined the possibilities of the endoscopic treatment of acute gallstone pancreatitis on the basis of the results of retrospective investigation of 19 middle-european endoscopic centers. There were altogether 11,830 EST in these centers; in 261 out of them the indication of EST was acute gallstone pancreatitis. They consider the exact and early diagnosis very important that can be based on the typical clinical and laboratory signs and ultrasonography. The ERCP reassures the final diagnosis and at the same time the therapeutic solution--EST--can also be realized. This took place within the first 48 hours. The results were favourable, in 90.4%, the complaints decreased significantly within 24 hours. The complication rate was 4.9%, and the mortality rate was 1.9%. These results are better than those of the conservative therapy.

Ampulla of Vater↗
PubMed1989

[Testosterone-dihydrotestosterone ratio in the differential diagnosis of pancreatic disease].

Serum testosterone (T), dihydrotestosterone (DT) and androstendione (AD) concentration were determined in male patients with pancreatic cancer (n = 14), chronic pancreatitis (n = 26), other malignancies of the gastrointestinal tract (n = 19) and in control subjects (n = 16). The T level was decreased in patients with pancreatic cancer relative to other groups of patients but the difference was not statistically significant. The T/DT ratio was significantly lower in pancreatic cancer (2.5 +/- 1.0) compared to chronic pancreatitis (9.6 +/- 2.3, p 0.01). The specificity of the ratio is 84%, while the sensitivity was found to be 92%. The discriminative value was found to be 4. The T/DT ratio seems to be a valuable marker in the differentiation of pancreatic cancer from chronic pancreatitis.

Diagnosis, Differential↗
PubMed1989

Long acting somatostatin analogue in dumping syndrome.

The effect of long acting somatostatin analogue, SMS 201-995, on postprandial dumping syndrome was studied in eight patients with Billroth II gastric resection. Each patient was subjected to two oral glucose challenges with 75 g glucose. One challenge was premedicated with 50 micrograms SMS 201-995 subcutaneously 15 min before the oral intake of glucose, the other with placebo. With placebo all patients experienced the subjective symptoms of the early dumping syndrome with significant (P less than 0.001) increases (mean (s.d.)) in pulse rate (from 66 (8) to 102 (10) beats/min), in packed cell volume (from 0.36 (0.05) to 0.43 (0.1) l/l) and in the plasma levels of vasoactive intestinal polypeptide (from 3.0 (0.5) to 10.2 (1.8) pmol/l). During the somatostatin study the subjective symptoms and the changes in the various parameters were not detected. In the control study seven patients showed postprandial hypoglycemia. In these patients significant elevations (P less than 0.001) in the insulin level (from 10 (0.9) to 40 (9.1) microE/ml) and gastric inhibitory peptide (GIP) concentration (from 100 (13) to 220 (41) ng/l) were seen, compared with the initial values. During the application of SMS 201-995 hypoglycaemia did not develop and plasma insulin and GIP concentrations remained unchanged. These results indicate that the long acting somatostatin analogue alleviates the symptoms of early and late postprandial dumping syndromes.

Double-Blind Method↗
PubMed1989

Somatostatin versus cimetidine in the treatment of actively bleeding duodenal ulcer: a prospective, randomized, controlled trial.

In a double-blind, prospective, randomized trial, the healing effect of somatostatin was compared with that of cimetidine in 67 patients with endoscopically confirmed duodenal ulcer with active bleeding (33 patients were treated with somatostatin, 34 with cimetidine). Intravenous infusion of either drug was administered for 48 or 72 h. Somatostatin had a higher rate of control of bleeding (30 vs. 24 patients at 72 h; p less than 0.05) and had less mean transfusion requirements (4.4 vs. 5.8 units; p less than 0.01). Need for surgical intervention and the mortality figures show a trend in favor of somatostatin. There was no difference in rebleeding rate.

Aged↗