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  • 1
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Histamine release could be shown in 50% of the dogs suffering from acute haemorrhagic pancreatitis in Pfeffer's preparation. The survival time of these dogs was shorter by about 50% than that of animals without alteration of the plasma histamine levels. The powerful diamine oxidase blocker aminoguanidine diminished the incidence of severe pancreatitis in the dogs without influencing survival time. As in animals treated by saline histamine release could be shown in 50% of the aminoguanidine-treated dogs in which higher plasma histamine levels were determined than in saline-treated animals. The survival time of the dogs with histamine release, however, was not different from that of animals with normal plasma histamine levels throughout the experiment. The actions of aminoguanidine in Pfeffer's preparation seemed to be rather complex. Contrasting effects on the development of pancreatitis and on histamine inactivation may have influenced the survival time in different directions.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Inflammation research 8 (1978), S. 372-375 
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A high histamine content was found in all areas of human gastric and duodenal mucosa. In single subjects there was no general preference of histamine being located predominantly in fundus and corpus. In biopsy specimens of human corpus mucosa many histamine-containingo-PD reactive cells could be identified. In the sections treated previously witho-PD also many toluidine blue staining cells (mast cells) could be visualized. As shown by a transcription technique their place and number was the same as those ofo-PD reacting cells. It is concluded that histamine in human corpus mucosa is localized exclusively in mast cells which seem to participate in acid secretion and in duodenal ulcer disease in man.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Acute haemorrhagic lesions in the oesophagus, stomach and duodenum (‘stress ulcers’) occur relatively often under clinical conditions and are always dangerous to the patient (lethality rate about 70%). Since conservative and surgical treatment are without significant success up to now, prevention by adaptation to stressors or by administration of drugs seems mandatory. An improved technique for producing acute gastric lesions in rats by immobilization and a new method for assessing this disease in the animals is presented in this communication. High precision is obtained within a single experimental series especially from day to day. Since histamine was suggested to be involved in the pathogenesis of stress ulcer disease, (+)-catechin, a rather specific inhibitor of specific histidine decarboxylase from rat stomach, was tested in immobilized rats. It prevented the formation of acute gastric lesions by 80% in seven series of experiments lasting for half a year. Since the drug has low toxicity in man, it is recommended for clinical trials.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusion All plasma substitutes in clinical use caused analphylactoid reactions in man and dog, but histamine release into the plasma or whole blood was related to them only in the case of Haemaccel. Thus a rational treatment or prophylaxis of this clinical hazard by H1- and H2-receptor antagonists can be attempted only in the case of Haemaccel [5].
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Several preparations of Cremophor El®, several of other non-ionic detergents and several components of Cremophor El were tested for their histamine-releasing capacity in dogs. Lutensol AP 10 and a derivative of 1,2-propylenglycol were ineffective, but showed excellent properties as detergents. Thus the histamine-releasing capacity was not necessarily combined with the tenside effect of the surfactants. Oleic acid found in Tween 80 as well as in Cremophor El seems to be the most effective constituent, but the alcohol seems also to be important for the histamine-releasing capacity. The development of a non-toxic solubilizer for lipophilic drugs seems of considerable clinical interest.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract From a methodological point of view the relevance of clinical-biochemical trials depends on the answers to mainly four complexes of questions: (1) the reliability of the assays in the clinical situation to be tested, (2) the precision and accuracy of sample-taking, (3) the qualification of the design and the protocols in the clinical part of the trial and (4) the usefulness of the time concepts in the trial concerning biorhythms, seasonal influences, psychological trauma of diagnostic procedures and treatment. In this study mainly the second complex of questions was studied intensely. The precision of the fluorometric histamine assay in biopsy specimens from human gastric mucosa depended on several conditions: Biochemical technique, sample preparation and removal of biopsies from gastric mucosa via endoscopy. The CV% of the whole procedure was about 8-times higher than that of the biochemical technique. In clinical-biochemical studies on the significance of histamine or any other hormone (such as gastrin) in any disease (such as duodenal ulcer) it seems therefore useless to describe the precision of an assay only by the variance of the biochemical technique. Calculation of the histamine content as mean of 3 samples reduced the CV% from 27.2 to 14.9% and should therefore be recommended. The accuracy of the fluorometric histamine assay in biopsy specimens has been tested by several methods recommended by the IFCC and was found to be satisfactory. Conflicing results in the literature concerning the histamine content of human gastric mucosa could be explained on a methodological basis.
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  • 8
    ISSN: 1432-1440
    Keywords: Plasma histamine ; operations ; anaesthesia ; plasma substitutes ; acute gastro intestinal ulcers ; Plasmahistaminspiegel ; Operationen ; Narkose ; Blutersatzmittel ; Streßulcus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Histaminkonzentrationen in Plasma, Vollblut und verschiedenen Geweben von Mensch. Affe, Schwein und Hund wurden vor, während und nach Operationen mit fluorometrischen Methoden gemessen. nach intraabdominellen eingriffen wurden bei 6 von 22 Patienten erhöhte Plasmahistaminspiegel noch Stunden nach der Operation gefunden. Als Ursachen der Histaminfreisetzung bei Operationen wurden nachgewiesen: Prämedikation durch Atropin, Anästhesieeinleitung mit intravenös verabreichten Kurznarkotika, Infusion von Plasmasubstituten und Manipulationen am Darm. Akuter Blutverlust war ohne Einfluß auf die Plasmahistaminspiegel. Klinische Symptome und pathophysiologische Reaktionen, wie Tachykardie, arterielle Hypotension, erhöhte Magensekretion und anaphylaktoide Reaktionen konnten auf Histaminfreisetzung unter bestimmten Umständen zurückgeführt werden.
    Notes: Summary Histamine concentrations in plasma, whole blood and various tissues of human subjects, monkeys, pigs and dogs were determined by fluorometric methods before, during and after surgical operations. Following intraabdominal surgery in 6 of 22 patients elevated plasma histamine levels were found several hours after the end of operation. Some of the causes of histamine release in surgery were found to be premedication by atropine, intravenously administered anaesthetics, infusion of plasma substitutes and manipulation on the gut. Acute blood losses were without effect on the plasma histamine levels. Clinical symptoms and pathophysiological reactions, such as tachycardia, hypotension, increased gastric secretion and anaphylactoid reactions could be related to the release of histamine in some circumstances.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1440
    Keywords: Streßulcus ; Ärztliche Ethik ; Sequentialstudie ; Cimetidin ; Schweres Polytrauma ; Stress ulceration ; Medical ethics ; Sequential trial ; Cimetidine ; Severe polytrauma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In patients in a surgical intensive care unit a controlled clinical trial was performed concerned with the pathophysiological functions of histamine in stress ulcer disease and with the influence of cimetidine prophylaxis on this complication. The commonly used organization of a controlled clinical trial was enforced to be changed by considerable theoretical, ethical and practical difficulties in designing and conducting the study: (1) Initially the trial was planned as randomized double-blind using a fixed sample size of patients obtained from the intensive care unit. It was executed as a sequential single-blind study only in patients with severe polytrauma. For ethical reasons it was stopped before the bounderies were reached and was analysed according to the advice of an external referee using Fisher's exact test (p〈0.025). (2) The necessary informations about the trial could not be compressed to one single report. As one of several parts this article mainly deals with Design, Clinical materials, Methods and Statistics of the whole investigation. Distinctive sections on Theoretical and Ethical issues and on Historical development of the study were included. Numerous decisions were explained already in Materials and Methods to emphasize the enormous complexity of the decision process in clinical trials in contrast to that in most of the animal experiments. (3) In order to facilitate conclusions from our sample to the target population and to define subgroups of patients with a high risk for stress ulceration all 6,634 patients hospitalized in the Surgery Clinic during the time of the study were prospectively investigated for clinically manifest stress ulceration. Furthermore as one of the most important attributes the lethality rate was calculated for the whole group and various subgroups of trauma patients in our hospital. As a surprising and remarkable result of the study clinically manifest stress ulcers occurred exclusively in our patients in the intensive care unit and among them mainly in those with severy polytrauma and postoperative complications. Cimetidine was highly effective in preventing stress ulceration in severe polytrauma patients. But it seems absolutely unnecessary to distribute this drug in all patients of a surgical intensive care unit like from a cornucopia of happiness.
    Notes: Zusammenfassung Bei Patienten der chirurgischen Wach- und Intensivstation wurde eine kontrollierte klinische Studie über den Wert von Cimetidin zur Streßulcusprophylaxe durchgeführt. Die übliche Organisation und Darstellung einer kontrollierten Studie mußte wegen erheblicher theoretischer, ethischer und praktischer Schwierigkeiten bei Planung und Durchführung geändert werden: (1) Zuerst wurde die Untersuchung bei Patienten der Wach- und Intensivstation als randomisierte Doppelblindstudie mit fixem Stichprobenumfang geplant. Ausgeführt wurde eine einfach-blinde Sequentialstudie ausschließlich bei Patienten mit schwerem Polytrauma. Kurz vor Erreichen der vorgegebenen Signifikanzgrenzen wurde sie aus ethischen Gründen abgebrochen und nach Beratung mit einem externen Gutachter mit Hilfe des exakten Testes nach Fisher analysiert (p〈0,025). (2) Die notwendigen Informationen über die Studie konnten nicht in einem einzigen Bericht zusammengepreßt werden. Als einer der Teile enthält diese Mitteilung Plan, Klinisches Material, Methoden und Statistik der Studie. Abschnitte über „Theoretische und ethische Aspekte“ und über „Historische Entwicklung der Studie“ wurden eingefügt. Zahlreiche Entscheidungen wurden bereits in Material und Methodik erläutert, um die enorme Komplexität des Entscheidungsprozesses bei klinischen Studien im Gegensatz zu der bei Tierexperimenten hervorzuheben. (3) Um Schlüsse von der Stichprobe auf die Zielpopulation zu erleichtern und Risikogruppen für Streßulkusentstehung zu definieren, wurden alle 6,634 Patienten der Klinik während der Dauer der Studie prospektiv auf klinisch-manifeste Streßläsionen untersucht. Als eines der wichtigsten Merkmale wurde weiterhin die Letalitätsrate für die Gesamtgruppe und für Untergruppen der Traumapatienten in unserer Klinik ermittelt. Streßulcera traten nur bei Patienten der Wachund Intensivstation auf, vor allem bei Patienten mit schwerem Polytrauma und postoperativen Komplikationen. Cimetidin verhütete sie äußerst wirksam beim schwer Polytraumatisierten. Es ist aber unnötig, das Arzneimittel über die Wach- und Intensivstation auszustreuen wie aus einem Füllhorn des Glücks.
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  • 10
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Clinical & experimental allergy 15 (1985), S. 0 
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In fourteen patients with food allergy, intragastral provocation under endoscopical control (IPEC) was performed. In all patients positive immediate-type reactions of the gastric mucosa were observed consisting of oedema, erythema and petechial bleeding. Microscopically, mast cell degranulation was observed and measured by mast cell counts using the o-phthaldialdehyde technique. Concomitantly, tissue histamine content in gastric mucosa decreased significantly after allergen provocation, while there was no change in normal volunteers. Plasma histamine concentration increased in most patients; the increases were most evident in four patients showing mild systemic reactions (urticaria and bronchospasm). The technique described might prove to be useful in establishing the diagnosis in doubtful cases of food allergy.
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