Figulla, Hans Reiner

[["dc.bibliographiccitation.firstpage","239"],["dc.bibliographiccitation.issue","4"],["dc.bibliographiccitation.journal","Metabolic Brain Disease"],["dc.bibliographiccitation.lastpage","251"],["dc.bibliographiccitation.volume","14"],["dc.contributor.author","Wiltfang, Jens"],["dc.contributor.author","Nolte, Wilhelm"],["dc.contributor.author","Otto, Markus"],["dc.contributor.author","Wildberg, Jens"],["dc.contributor.author","Bahn, Erik"],["dc.contributor.author","Figulla, Hans Reiner"],["dc.contributor.author","Pralle, Lars"],["dc.contributor.author","Hartmann, Heinz"],["dc.contributor.author","Rüther, Eckhard"],["dc.contributor.author","Ramadori, Giuliano"],["dc.date.accessioned","2017-09-07T11:44:42Z"],["dc.date.available","2017-09-07T11:44:42Z"],["dc.date.issued","1999"],["dc.description.abstract","Portal-systemic encephalopathy is the prototype among the neuropsychiatric disorders that fall under the term Hepatic Encephalopathies. Ammonia toxicity is central to the pathophysiology of Portal-systemic encephalopathy, and neuronal ammonia toxicity is modulated by activated astrocytes. The calcium-binding astroglial key protein S100β is released in response to glial activation, and its measurement in serum only recently became possible. Serum S100β was determined by an ultrasensitive ELISA in patients (n=36) with liver cirrhosis and transjugular intrahepatic portosystemic stent-shunt. Subclinical portal-systemic encephalopathy and overt portal-systemic encephalopathy were determined by age-adjusted psychometric tests and clinical staging, respectively. Serum S100β was specifically elevated in the presence of subclinical or early portal-systemic encephalopathy, but not arterial ammonia. S100β levels elevated above a reference value (S100β ≤ 110pg/ml) or the cut off value determined in our group of patients (112pg/ml) predicted subclinical portal-systemic encephalopathy with a specificity and sensitivity of 100 and 56.5%, respectively. Serum S100β was significantly dependent on liver dysfunction (Child-Pugh score), but was more closely related to cognitive impairments than the score. Serum S100β seems to be a promising biochemical surrogate marker for mild cognitive impairments due to portal-systemic encephalopathy."],["dc.identifier.doi","10.1023/a:1020785009005"],["dc.identifier.gro","3151726"],["dc.identifier.pmid","10850551"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/8547"],["dc.language.iso","en"],["dc.notes.status","final"],["dc.notes.submitter","chake"],["dc.relation.issn","0885-7490"],["dc.title","Elevated Serum Levels of Astroglial S100β in Patients with Liver Cirrhosis Indicate Early and Subclinical Portal-Systemic Encephalopathy"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","no"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","60"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Liver International"],["dc.bibliographiccitation.lastpage","65"],["dc.bibliographiccitation.volume","20"],["dc.contributor.author","Nolte, Wilhelm"],["dc.contributor.author","Ehrenreich, Hannelore"],["dc.contributor.author","Wiltfang, Jens"],["dc.contributor.author","Pahl, Karoline"],["dc.contributor.author","Unterberg, Knut"],["dc.contributor.author","Kamrowski-Kruck, Heike"],["dc.contributor.author","Schindler, Christian G."],["dc.contributor.author","Figulla, Hans Reiner"],["dc.contributor.author","Buchwald, Arnd B."],["dc.contributor.author","Hartmann, Heinz"],["dc.contributor.author","Ramadori, Giuliano"],["dc.date.accessioned","2017-09-07T11:44:24Z"],["dc.date.available","2017-09-07T11:44:24Z"],["dc.date.issued","2000"],["dc.description.abstract","Aims/Background: Endothelin-1 (ET-1) may be a mediator for portal hypertension in liver cirrhosis. The aim of the present study was to determine the concentrations of ET-1 in the systemic and splanchnic circulation before and after reduction of portal hypertension by transjugular intrahepatic portosystemic shunt implantation (TIPS). Methods: Plasma concentrations of immunoreactive ET-1 were measured in peripheral venous blood samples from 25 patients with liver cirrhosis before and at 1, 3, 9 and 15 months after TIPS. Furthermore, acute effects of TIPS on ET-1 were studied in plasma samples from the hepatic vein, the portal vein 30 minutes before and after TIPS and in the femoral artery (only after TIPS) in a subgroup of 15 patients. In addition, the portocaval pressure gradient was determined before and after TIPS. Results: Before TIPS peripheral venous plasma ET-1 concentrations (n=25; median 4.2 pg/ml; range 1.9–14.7) were significantly increased in patients with refractory ascites (n=7; median 7.8, range 3.5–14.7) compared to patients with repetitive bleeding (n=18; median 3.4; range 1.9–7.1) (p=0.003). Furthermore, peripheral ET-1 concentrations correlated with the degree of liver dysfunction according to the Child-Pugh classification (Spearman's r=0.46; p=0.02). Following TIPS, peripheral ET-1 concentrations remained unchanged during a follow-up of 15 months. Before TIPS, a positive gradient of ET-1 concentrations from portalvenous to hepatovenous and peripheral venous levels was found (p<0.03). Immediately after TIPS, arterial ET-1 concentrations reached markedly increased levels in individual patients (88, 92 and 103 pg/ml). Severe systemic reactions to these high levels were not observed. Peripheral venous, hepatovenous and portalvenous ET-1 concentrations did not correlate with portocaval pressure gradients. Conclusion: Cirrhotic patients demonstrated unchanged peripheral venous ET-1 concentrations up to 15 months after TIPS. Portal congestion was associated with increased ET-1 levels in the prehepatic splanchnic area. The effect of portal decompression on splanchnic and systemic ET-1 levels deserves further investigation."],["dc.identifier.doi","10.1034/j.1600-0676.2000.020001060.x"],["dc.identifier.gro","3151647"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/8464"],["dc.language.iso","en"],["dc.notes.status","final"],["dc.notes.submitter","chake"],["dc.relation.issn","1478-3223"],["dc.title","Systemic and splanchnic endothelin-1 plasma levels in liver cirrhosis before and after transjugular intrahepatic portosystemic shunt (TIPS)"],["dc.type","journal_article"],["dc.type.internalPublication","unknown"],["dc.type.peerReviewed","no"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","818"],["dc.bibliographiccitation.issue","6"],["dc.bibliographiccitation.journal","Journal of Hepatology"],["dc.bibliographiccitation.lastpage","824"],["dc.bibliographiccitation.volume","34"],["dc.contributor.author","Nolte, W."],["dc.contributor.author","Schindler, C. G."],["dc.contributor.author","Figulla, H. R."],["dc.contributor.author","Wuttke, Wolfgang"],["dc.contributor.author","Hufner, M."],["dc.contributor.author","Hartmann, Hans"],["dc.contributor.author","Ramadori, Giuliano"],["dc.date.accessioned","2018-11-07T09:00:58Z"],["dc.date.available","2018-11-07T09:00:58Z"],["dc.date.issued","2001"],["dc.description.abstract","Background/Aims: Liver cirrhosis is frequently associated with sexual dysfunction and hormonal abnormalities, To evaluate the effect of portosystemic shunting on sex steroid serum concentrations, a prospective study was performed in cirrhotic patients treated consecutively and electively by transjugular intrahepatic portosystemic stent shunt (TIPS). Methods: In 27 patients with liver cirrhosis we measured serum levels of testosterone (T), sexual hormone binding globulin (SHBG), luteinizing hormone, follicle-stimulating hormone, dehydroepiandrosterone sulfate, androstenedione (A), estradiol (E-2), 17-OH-progesterone and the T/SHBG ratio before and 3 months after TIPS, Results: In men (n = 17) 3 months after TIPS, A and E-2 significantly increased, with mean serum levels rising from 4.4 +/- 2.5 to 5.6 +/- 2.9 ng/ml (P = 0.04) and from 27 +/- 9 to 40 +/- 19 pg/ml (P = 0.003), respectively. In contrast to A the increase of E-2 persisted at 9 and 15 months after TIPS, Erectile dysfunction increased from 30% before TIPS to 70% after TIPS, In women (n = 10) A and E-2 levels did not change significantly after TIPS. Conclusions: TIPS aggravated hormonal dysbalance of ses steroids in favor of estrogens (hyperestrogenism) in men, (C) 2001 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved."],["dc.identifier.doi","10.1016/S0168-8278(01)00052-6"],["dc.identifier.isi","000169542500005"],["dc.identifier.pmid","11451164"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/24297"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Elsevier Science Bv"],["dc.relation.issn","1600-0641"],["dc.relation.issn","0168-8278"],["dc.title","Increase of serum estradiol in cirrhotic men treated by transjugular intrahepatic portosystemic stent shunt"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","1215"],["dc.bibliographiccitation.issue","5"],["dc.bibliographiccitation.journal","Hepatology"],["dc.bibliographiccitation.lastpage","1225"],["dc.bibliographiccitation.volume","28"],["dc.contributor.author","Nolte, Wilhelm"],["dc.contributor.author","Wiltfang, Jens"],["dc.contributor.author","Schindler, Christian"],["dc.contributor.author","Münke, Hans"],["dc.contributor.author","Unterberg, Knut"],["dc.contributor.author","Zumhasch, Uta"],["dc.contributor.author","Figulla, Hans R."],["dc.contributor.author","Werner, Gerald"],["dc.contributor.author","Hartmann, Heinz"],["dc.contributor.author","Ramadori, Giuliano"],["dc.date.accessioned","2017-09-07T11:44:23Z"],["dc.date.available","2017-09-07T11:44:23Z"],["dc.date.issued","1998"],["dc.description.abstract","A prospective study of hepatic encephalopathy (HE) including neuropsychiatric and psychometric evaluation, electroencephalography, and determination of arterial ammonia levels was performed in 55 cirrhotic patients treated consecutively by transjugular intrahepatic portosystemic shunt (TIPS). The cumulative HE rate increased from 23.6% within the 3-month interval before TIPS to 50.9% within the first 3-month interval post-TIPS (P = .003). Significant and independent predictors of HE post-TIPS were the presence of HE pre-TIPS and reduced liver function. The cumulative HE rate declined in the second 3-month interval post-TIPS and reached the pre-TIPS level. Chronic forms of HE exceeding grade I were not observed. In a subgroup of 22 nonencephalopathic TIPS patients, the prevalence of subclinical HE did not change after TIPS. Among individual psychometric tests, the block design test gave the highest proportion of pathological results (about 50%), whereas selective reminding gave the lowest (10%-25%). Electroencephalography (EEG) showed a temporary increase of pathological results at 1 month after TIPS, when patients with overt HE (grade I) were included (proportion of 21.1% before vs. 57.1%, P = .005). Arterial ammonia concentration increased from a mean of 94 ± 26 μg/dL to 140 ± 28 μg/dL at 3 months after TIPS (P < .001). Elevated ammonia levels persisted. TIPS led to a temporary increase of HE incidence within 3 months. The decline of the HE rate beyond 3 months despite a sustained increase of arterial ammonia levels could not entirely be explained by reduction of shunt flow, nor by alteration of liver function. Instead, cerebral adaptation to gut-derived neurotoxins might be anticipated."],["dc.identifier.doi","10.1002/hep.510280508"],["dc.identifier.gro","3151638"],["dc.identifier.pmid","9794904"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/8454"],["dc.language.iso","en"],["dc.notes.status","final"],["dc.notes.submitter","chake"],["dc.relation.issn","0270-9139"],["dc.title","Portosystemic Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt in Patients With Cirrhosis: Clinical, Laboratory, Psychometric, and Electroencephalographic Investigations"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","no"],["dspace.entity.type","Publication"]]