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  • 1
    Electronic Resource
    Electronic Resource
    13C-methacetin breath test as liver function test in patients with chronic hepatitis C virus infection (2005)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 21 (2005), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : The 13C-methacetin breath test enables the quantitative evaluation of the cytochrome P450-dependent liver function.Aim : To find out whether this breath test is sensitive in noncirrhotic patients also with chronic hepatitis C in early stages of fibrosis.Methods : Sixty-one healthy controls and 81 patients with chronic hepatitis C underwent a 13C-methacetin breath test. In all patients, a liver biopsy was performed. The liver histology was classified according to the histology activity index–Knodell score.Results : Delta over baseline values of the patients at 15 min significantly differed from controls (19.2 ± 9.2‰ vs. 24.1 ± 5.7‰; P 〈 0.003). The cumulative recovery after 30 min in patients was 11.4 ± 4.8% and in healthy controls 13.8 ± 2.8% (P 〈 0.002). However, patients with early fibrosis (histology activity index IVB) did not differ in delta over baseline values of the patients at 15 min (23.2 ± 7.9‰ vs. 22.6 ± 7.2‰; P = 0.61) or cumulative recovery (13.6 ± 3.7% vs. 13.2 ± 3.8%; P = 0.45) from patients with more advanced fibrosis (histology activity index IVC). Patients with clinically nonsymptomatic cirrhosis (histology activity index IVD; Child A) metabolized 13C-methacetin to a significantly lesser extent (delta over baseline values of the patients at 15 min: 8.3 ± 4.9‰; P 〈 0.005 and cumulative recovery after 30 min: 5.6 ± 3.2%; P 〈 0.003). The 13C-methacetin breath test identified cirrhotic patients with 95.0% sensitivity and 96.7% specificity.Conclusion : The non-invasive 13C-methacetin breath test reliably distinguishes between early cirrhotic (Child A) and noncirrhotic patients, but fails to detect early stages of fibrosis in patients with chronic hepatitis C.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.2005.02317.x
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  • 2
    Electronic Resource
    Electronic Resource
    Tilidine does not affect human sphincter of Oddi motility—a randomized, controlled study (1997)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 11 (1997), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: To investigate the effects of intravenous pentazocine and tilidine on sphincter of Oddi motility.〈section xml:id="abs1-2"〉〈title type="main"〉Methods:Twenty patients with suspected sphincter of Oddi dysfunction were enrolled in a prospective, double-blind study. Sphincter of Oddi motility was assessed by means of endoscopic manometry after injection of 0.9% saline, as well as after randomized dosing with either 30 mg pentazocine i.v. (n = 10) or 50 mg tilidine i.v. (n = 10).〈section xml:id="abs1-3"〉〈title type="main"〉Results:Pentazocine significantly increased the sphincter of Oddi baseline pressure from 32 ± 21 mmHg (saline) to 41 ± 19 mmHg (P = 0.002), whereas tilidine did not alter the sphincter baseline pressure (34 ± 15 mmHg saline vs. 36 ± 16 mmHg tilidine, P = 0.16). Furthermore, pentazocine increased the phasic sphincter contraction amplitude (108 ± 16 mmHg saline vs. 121 ± 18 mmHg pentazocine, P = 0.004), but tilidine was without any effect (125 ± 24 mmHg saline vs. 125 ± 21 mmHg tilidine, P = 0.93). The phasic sphincter of Oddi contraction frequency and duration were not influenced either by pentazocine or by tilidine.〈section xml:id="abs1-4"〉〈title type="main"〉Conclusion:In contrast to 30 mg of pentazocine, 50 mg of tilidine does not affect sphincter of Oddi motility. Therefore, tilidine can be used during endoscopic manometry and for analgesia in pancreatobiliary disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.1997.00221.x
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  • 3
    Electronic Resource
    Electronic Resource
    The new DR-70 immunoassay detects cancer of the gastrointestinal tract: a validation study (2004)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 20 (2004), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : Malignant cells characteristically possess high levels of plasminogen activator, which induce local fibrinolysis. The DR-70 immunoassay is a newly developed test, which quantifies fibrin degradation products in serum by a proprietary antibody.Aim : To evaluate the DR-70 immunoassay as a detection assay for the presence of gastrointestinal cancers.Methods : We prospectively collected blood sera of 85 patients with histologically proven tumour and 100 healthy blood donors. Ten microlitres of the sera was used for the DR-70 immunoassay. Nineteen patients had a hepatocellular and 10 cholangiocellular carcinoma, 13 cancer of the pancreas, 30 colorectal cancer, 10 stomach cancer and three cancer of the oesophagus.Results : Receiver–operator curve analysis revealed 〈0.7 μg/mL as the best cut-off value to distinguish between patients with cancer and healthy controls. Using this cut-off value, the DR-70 immunoassay showed a good clinical performance with a sensitivity of 91% and a specificity of 93%. Patients with advanced tumour spread showed significantly higher DR-70 values than those with early-stage tumours (P 〈 0.0003).Conclusion : The DR-70 immunoassay reliably differs between cancer patients and healthy controls. Therefore, it promises to become a useful test for the detection of cancer in clinical practice.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.2004.02212.x
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  • 4
    Electronic Resource
    Electronic Resource
    Endoscopic injection of botulinum toxin in patients with recurrent acute pancreatitis due to pancreatic sphincter of Oddi dysfunction (2000)
    Oxford UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 14 (2000), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: To evaluate the technical feasibility, safety, and short-term efficacy of botulinum toxin injection for pancreatic sphincter of Oddi dysfunction and to analyse whether the symptomatic response to botulinum toxin might be a predictor of outcome for endoscopic sphincterotomy.〈section xml:id="abs1-2"〉〈title type="main"〉Methods:Fifteen consecutive patients (nine female, aged 38 ± 12 years) with frequent attacks (median four) of acute pancreatitis within 6 months, and manometrically proven pancreatic sphincter of Oddi dysfunction underwent endoscopic injection of 100 units of botulinum toxin into the major papilla. All patients underwent prospective follow-up thereafter and in cases of recurrent pancreatitis manometry this was repeated and pancreatic sphincterotomy was performed.〈section xml:id="abs1-3"〉〈title type="main"〉Results:No side-effects occurred after botulinum toxin injection in any patient. Within 3 months after botulinum toxin treatment, 12 out of 15 patients remained asymptomatic (80% primary response). Only one out of three patients without symptomatic benefit showed continued elevated pancreatic sphincter pressure at manometry and only this patient benefited from pancreatic sphincterotomy later on. Eleven of the 12 patients initially responding to botulinum toxin injection developed a symptomatic relapse 6 ± 2 months after botulinum toxin treatment. These patients then achieved long-term clinical remission from pancreatic or combined (biliary and pancreatic, n=5) sphincterotomy (median follow-up, 15 months).〈section xml:id="abs1-4"〉〈title type="main"〉Conclusion:Endoscopic botulinum toxin injection into the papilla of Vater is a safe procedure for treatment of pancreatic sphincter of Oddi dysfunction that may provide short-term relief in about 80% of the patients. Those patients who respond to botulinum toxin may subsequently gain definitive cure from sphincterotomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2000.00814.x
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  • 5
    Electronic Resource
    Electronic Resource
    Long-term cisapride treatment improves diabetic gastroparesis but not glycaemic control (2002)
    Oxford UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 16 (2002), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In patients with diabetic gastroparesis, delayed food delivery to the intestine may become a major obstacle to post-prandial glycaemic control.〈section xml:id="abs1-2"〉〈title type="main"〉Aim:To investigate whether cisapride accelerates gastric emptying in the long term or improves diabetes control in patients with diabetic gastroparesis.〈section xml:id="abs1-3"〉〈title type="main"〉Methods:Eighty-five patients with long-standing insulin-dependent diabetes mellitus (glycosylated haemoglobin (HbA1c) 〉 7.0%), dyspepsia and diabetic neuropathy were tested for impaired gastric emptying of solids by the 13C-octanoate breath test. Nineteen of these patients with severe diabetic gastroparesis (i.e. t1/2 〉 170 min) were randomly treated with 10 mg cisapride t.d.s. (n=9) or placebo (n=10) for 12 months. Thereafter, the breath test, dyspeptic symptoms and HbA1c values were reassessed.〈section xml:id="abs1-4"〉〈title type="main"〉Results:Half emptying times in nine patients with diabetic gastroparesis were significantly shortened by cisapride (175 ± 46 min vs. 227 ± 40 min; P 〈 0.03). Half emptying times in the 10 patients taking placebo did not change (205 ± 37 min vs. 211 ± 36 min, P=0.54). Cisapride significantly reduced dyspepsia (score: 4.1 ± 1.6 vs. 2.0 ± 0.5, P=0.002). HbA1c values after 12 months of treatment were not different (cisapride: 7.7 ± 0.4% vs. 7.6 ± 0.9%, P=0.76; placebo: 7.5 ± 0.6% vs. 7.6 ± 1.5%, P=0.89).〈section xml:id="abs1-5"〉〈title type="main"〉Conclusions:Prokinetic treatment with cisapride accelerates gastric emptying of solids and improves dyspeptic symptoms in diabetic gastroparesis. Glycaemic control, however, is not affected by cisapride.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2002.01257.x
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  • 6
    Electronic Resource
    Electronic Resource
    H2-receptor antagonists and antacids have an aggravating effect on Helicobacter pylori gastritis in duodenal ulcer patients (1997)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 11 (1997), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Antacids, such as aluminium–magnesium hydroxide (AlMg(OH)3), or H2-receptor antagonists, such as ranitidine, are common drugs used for treating peptic ulcer disease and acid-related symptoms. Methods: In a prospective double-blind controlled study, 174 patients were randomized to a 4-week course of treatment with either AlMg(OH)3 (acid-binding capacity: 280 mval/day) or ranitidine 300 mg for active Helicobacter pylori-associated duodenal ulcers (as determined by histology and the urease test). Before and after treatment, two biopsy specimens each were obtained from the antrum and corpus, and the grade and activity of gastritis, as well as H. pylori density, were determined using a score ranging from 0 = none to 4 = severe. Results: Pre- and post-treatment histology were available for 138 patients (AlMg(OH)3: 67, ranitidine: 71). Treatment with AlMg(OH)3 significantly increased the activity of corpus gastritis (Wilcoxon signed-rank: P = 0.0014), while ranitidine treatment significantly increased both the grade and activity of corpus gastritis (P = 0.0002 and P = 0.0001 respectively). In the antrum, both regimens provoked a significant increase in the frequency of intestinal metaplasia, but this may be a consequence of sampling error. Conclusions: Ranitidine and AlMg(OH)3 have an aggravating effect on H. pylori gastritis in duodenal ulcer patients. This should be considered a side-effect of the respective drugs and is more pronounced with ranitidine.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.1997.00196.x
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  • 7
    Electronic Resource
    Electronic Resource
    Influence of cisapride on antroduodenal motor function in healthy subjects and diabetics with autonomic neuropathy (1991)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 5 (1991), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Antroduodenal manometry was used to assess motility in 10 healthy volunteers and 15 diabetics with cardiac autonomic neuropathy whilst they received 20 mg cisapride orally or an apparently identical placebo. Interdigestive motility was recorded after an overnight fast and for 2 hours following a 500 kcal liquid meal. Active treatment did not influence the number or duration of interdigestive motility cycles in either group although antroduodenal co-ordination in both the fasting and the fed state was enhanced by cisapride (P 〈 0.05). In diabetics the postprandial antral motility index was increased by cisapride, whereas in healthy subjects antral and duodenal motility indices were increased both fasting and in the fed state (P 〈 0.05).These results suggest that impaired antroduodenal co-ordination is of importance in delaying gastric emptying by diabetic subjects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1991.tb00528.x
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  • 8
    Electronic Resource
    Electronic Resource
    Intestinale Permeabilität bei Patienten mit erworbenem Immundefekt — Syndrom (AIDS) (1991)
    Springer
    Journal of molecular medicine 69 (1991), S. 715-721 
    Details
    ISSN: 1432-1440
    Keywords: Intestinal permeability ; AIDS ; HIV-enteropathy ; Lactulose/rhamnose-ratio ; Crohn's disease ; Ulcerative colitis ; Celiac disease ; Small bowel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Intestinal permeability has been assessed as a parameter of the small intestinal barrier function in 33 patients with AIDS (WR 6), in 25 healthy volunteers, 32 patients with Crohn's disease, 18 patients with ulcerative colitis and in 12 patients with untreated coeliac disease. Permeability was measured by means of the 5 hour urinary excretion of lactulose and rhamnose after administration of these sugars (1 g rhamnose, 10 g lactulose) which allowed to calculate the urinary lactulose/rhamnose — ratio (L/R-r) as an index of intestinal permeability. Compared to the controls (L/R-r=0,014±0,010) patients with AIDS had significantly increased lactulose/rhamnose — ratios (0,189+0,164;p〈0.01) indicating abnormal permeation both of lactulose and rhamnose. This alteration of intestinal permeability was more pronounced than the significant increase of the L/R-r in the patients with either Crohn's disease or coeliac disease. However, intestinal permeability was not altered in the patients with ulcerative colitis. Among the patients with AIDS, the most abnormal permeability ratios were observed in two subjects with intestinal cryptosporidiosis. This investigation demonstrates by means of the “double sugar ratio”, that intestinal permeability in patients with AIDS is highly abnormal, the impairment being even more abnormal than in patients with other small intestinal disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01649441
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  • 9
    Electronic Resource
    Electronic Resource
    Einfluß von Cisaprid auf die Oesophagusmotilität bei Gesunden und Patienten mit progressiver systemischer Sklerodermie (1990)
    Springer
    Journal of molecular medicine 68 (1990), S. 602-607 
    Details
    ISSN: 1432-1440
    Keywords: Esophageal motility ; Cisapride ; Progressive systemic sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Prokinetic agents might be useful in patients with progressive systemic sclerosis (PSS) who have disturbed function of the lower esophageal sphincter and impaired acid-clearance of the tubular esophagus. We therefore compared, by means of esophageal manometry, the effect of 20 mg cisapride orally vs. placebo in 12 patients with progressive systemic sclerosis and proven esophageal dysfunction as well as in 10 healthy volunteers in a double-blind, prospective trial. An increase of the lower esophageal resting pressure from 18.1±2.4 mm Hg to 23.9±8.1 mm Hg* after cisapride administration was observed in healthy volunteers, and from 10.9±3.2 mm Hg to 13.6+4.0 mm Hg* in the PSS patients. The amplitudes of peristaltic waves in the distal part of the esophagus were increased by cisapride from 83.8±10.6 mm Hg to 95.6±15.5mm Hg* in volunteers and from 28.9+12.8 mm Hg to 36.8±16.2 mm Hg in patients (*:P〈0.05). These results indicate that cisapride has a therapeutic rationale in the treatment of esophageal dysfunction in PSS; further clinical investigations are justified.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01660958
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  • 10
    Electronic Resource
    Electronic Resource
    Book review (1992)
    Springer
    Journal of molecular medicine 70 (1992), S. 587-587 
    Details
    ISSN: 1432-1440
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00184799
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