Nolte, Wilhelm

[["dc.bibliographiccitation.firstpage","521"],["dc.bibliographiccitation.issue","9"],["dc.bibliographiccitation.journal","MEDIZINISCHE KLINIK"],["dc.bibliographiccitation.lastpage","528"],["dc.bibliographiccitation.volume","96"],["dc.contributor.author","Nolte, W."],["dc.contributor.author","Ramadori, Giuliano"],["dc.date.accessioned","2018-11-07T08:38:57Z"],["dc.date.available","2018-11-07T08:38:57Z"],["dc.date.issued","2001"],["dc.description.abstract","Background: Despite a decrease in both the incidence of colorectal carcinoma and the mortality due to this disease, it is still the second most common cause of death in the Western world. Refined surgery and adjuvant chemotherapy have not been able to prevent the frequent recurrence of colorectal cancer, often in a nonresectable state. In this palliative situation, which may already occur during initial presentation, the following treatment is indicated: best Supportive care and a differential and stepwise chemotherapy. Palliative chemotherapy retards the progression of cancer disease and improves Survival (from 6-9 months to 15-18 months). Chemotherapy Should already be started in asymptomatic patients, if cancer disease is progressive. Chemotherapy: 5-fluorouracil (5-FU) remains the key drug for palliative chemotherapy. Drug effects and side effects critically depend oil the mode of application and oil biomodulation (e.g. by folinic acid [leucovorin, LV]). Compared with the traditional bolus therapy of 5-FU/LV, we prefer infusional therapy for 24 hours because of its higher effectivity and fewer side effects. Further drugs that may be given in addition to or as ail alternative to 5-FU, are sodium folinate, raltitrexed and oral fluoropyrimidines (so-called prodrugs, e.g., capecitabine and tegafur-uracil [UFT]). These drugs are still under clinical investigation. Capecitabine, ill particular, appears to be a useful alternative for intravenous 5-FU therapy. When compared with the traditional 5-FU bolus therapy (Mayo regimen), capecitabine is at least equally effective, but has fewer side effects. Furthermore, it call be given orally. If treatment failure occurs under 5-FU, the application of oxaliplatin or irinotecan may be useful for second- and third-line therapy (partial remission rates of 10% or 13-15%). First-Line Therapie: Four randomized Phase-III studies demonstrate the effectiveness of additional therapy with oxaliplatin and irinotecan in combination with 5-FU for first-line chemotherapy of colorectal cancer. Triple therapy improves remission rates, quality of life and (shown only for irinotecan/ 5-FU/LV) survival rate, but causes more side effects and costs."],["dc.identifier.doi","10.1007/PL00002237"],["dc.identifier.isi","000171248700002"],["dc.identifier.pmid","11603115"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/18875"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Urban & Vogel"],["dc.relation.issn","0723-5003"],["dc.title","New aspects in the palliative treatment of metastatic colorectal carcinoma"],["dc.type","review"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","209"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","OSTEOLOGIE"],["dc.bibliographiccitation.lastpage","216"],["dc.bibliographiccitation.volume","18"],["dc.contributor.author","Siggelkow, Heide"],["dc.contributor.author","Cortis, Judith"],["dc.contributor.author","Claus, Ch."],["dc.contributor.author","Funke, M."],["dc.contributor.author","Nolte, W."],["dc.contributor.author","Huefner, Michael"],["dc.contributor.author","Raddatz, Dirk"],["dc.date.accessioned","2018-11-07T08:35:18Z"],["dc.date.available","2018-11-07T08:35:18Z"],["dc.date.issued","2009"],["dc.description.abstract","Crohn's disease (CD) is associated with reduced bone mineral density and increased fracture risk. To assess the effects of the inflammatory process itself on bone parameters, we investigated patients with active CD and in remission without glucocorticoid treatment four weeks prior to analysis. Patients with active CD were compared to age- and sex-matched healthy volunteers and osteoporosis patients. Bone mineral density, bone formation and resorption markers were assessed, in addition to simple inflammatory markers and cytokines. Out of seven patients with active disease, three had osteopenia and one osteoporosis (WHO definition). The erythrocyte sedimentation rate (ESR) was associated with BMD at the femoral neck (R(2) = 0.853, p<0.01) and the spine (R(2)=0.772, p<0.05). ESR seems to influence bone formation, as shown by lower bone alkaline phosphatase with high ESR (R(2)=0.725, R=-0.852, p<0.05). The clinical disease activity score was not useful in determining patients' risk of acquiring bone disease. in conclusion, in patients with Crohn's disease, the degree of the inflammatory process as assessed by ESR indicates bone loss and might be of value in identifying patients at risk of developing osteoporosis."],["dc.identifier.isi","000271412000009"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/18032"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Verlag Hans Huber"],["dc.relation.issn","1019-1291"],["dc.title","Erythrocyte sedimentation rate as an osteoporosis risk factor in patients with active Crohn's disease"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","443"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","Journal of Hepatology"],["dc.bibliographiccitation.lastpage","449"],["dc.bibliographiccitation.volume","29"],["dc.contributor.author","Nolte, Wilhelm"],["dc.contributor.author","Wiltfang, Jens"],["dc.contributor.author","Schindler, Christian G."],["dc.contributor.author","Unterberg, Knut"],["dc.contributor.author","Finkenstaedt, Michael"],["dc.contributor.author","Niedmann, Peter D."],["dc.contributor.author","Hartmann, Heinz"],["dc.contributor.author","Ramadori, Giuliano"],["dc.date.accessioned","2017-09-07T11:44:25Z"],["dc.date.available","2017-09-07T11:44:25Z"],["dc.date.issued","1998"],["dc.description.abstract","Background/Aims: Deposition of paramagnetic substances in basal ganglia, resulting in increased signals in T1-weighted magnetic resonance images (bright basal ganglia), is frequently seen in liver cirhrosis. The present study describes the prevalence of bright basal ganglia and its clinical significance in patients with long-standing portal vein thrombosis in the absence of liver cirrhosis.Methods: Six patients with angiographically proven complete portal vein thrombosis and cavernomatous transformation without signs of acute or chronic liver disease were studied by magnetic resonance imaging of the brain, neuropsychiatric evaluation, psychometric tests, electroencephalography, and determination of arterial ammonia levels and of serum manganese concentrations from peripheral venous blood.Results: Five out of six patients demonstrated increased signal intensity in the basal ganglia. Overt portal-systemic encephalopathy was not noted prior to or at the time of evaluation. Normal EEG results were recorded in all patients. Only one of the six patients had pathological results in at least two out of four psychometric tests. This latter patient had had a large right-sided brain infarction. Arterial ammonia concentrations were normal in four of the six patients; one patient with increased ammonia levels had concomitant renal insufficiency with azotemia. The other four patients had no relevant concomitant diseases. Serum manganese levels were non-significantly increased compared with control group (p=0.06), but they were significantly correlated to basal ganglia signal intensity (R=0.88; p=0.02).Conclusions: Our results demonstrate that bright basal ganglia primarily represent shunt-induced alterations. They are not directly associated with disturbed liver function nor with portal-systemic encephalopathy."],["dc.identifier.doi","10.1016/s0168-8278(98)80063-9"],["dc.identifier.gro","3151659"],["dc.identifier.pmid","9764992"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/8476"],["dc.language.iso","en"],["dc.notes.status","final"],["dc.notes.submitter","chake"],["dc.relation.issn","0168-8278"],["dc.title","Bright basal ganglia in T1-weighted magnetic resonance images are frequent in patients with portal vein thrombosis without liver cirrhosis and not suggestive of hepatic encephalopathy"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","no"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","389"],["dc.bibliographiccitation.issue","4"],["dc.bibliographiccitation.journal","European Journal of Gastroenterology & Hepatology"],["dc.bibliographiccitation.lastpage","395"],["dc.bibliographiccitation.volume","16"],["dc.contributor.author","Wietzke-Braun, Perdita"],["dc.contributor.author","Schindler, C."],["dc.contributor.author","Raddatz, Dirk"],["dc.contributor.author","Braun, F."],["dc.contributor.author","Armbrust, T."],["dc.contributor.author","Nolte, W."],["dc.contributor.author","Ramadori, Giuliano"],["dc.date.accessioned","2018-11-07T10:49:51Z"],["dc.date.available","2018-11-07T10:49:51Z"],["dc.date.issued","2004"],["dc.description.abstract","Objective Patients with non-resectable liver metastases of colorectal cancer have poor prognosis and are mainly treated by palliative chemotherapy. Laser interstitial thereto-therapy is an innovative minimal invasive procedure for local tumour destruction within solid organs. The aim of the study was to investigate quality of life and outcome of ultrasound-guided laser interstitial thermotherapy (US-LITT) in patients with liver metastases of colorectal cancer. Methods In this prospective non-randomized study, 45 patients with liver metastases of colorectal cancer were palliatively treated by US-LITT. Patient survival was analysed by the Kaplan-Meier method and the quality of life by questionnaire C30 of the European Organisation for Research and Treatment of Cancer before, and 1 week, 1 month, and 6 months after initiation of US-LITT. Results Median survival after initiation of US-LITT was 8.5 +/- 0.7 months with a range of 1.5-18 months. Body weight was constant 1 month after US-LITT. In the multivariate analyses, quality-of-life symptoms and functioning scales did not deteriorate in patients alive at 6 months after initiation of US-LITT. Univariate analyses outlined a significant increase of the pain subscale before and at 1 week after US-LITT. Conclusions This study first describes the quality of life in patients with liver metastases of colorectal cancer treated by US-LITT. Potential benefits of the minimal invasive procedure could be prolonged survival time by preserved quality of life, but this first impression needs to be verified in a comparative study."],["dc.identifier.doi","10.1097/00042737-200404000-00004"],["dc.identifier.isi","000220655900004"],["dc.identifier.pmid","15028971"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/48527"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Lippincott Williams & Wilkins"],["dc.relation.issn","0954-691X"],["dc.title","Quality of life and outcome of ultrasound-guided laser interstitial thereto-therapy for non-resectable liver metastases of colorectal cancer"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","413"],["dc.bibliographiccitation.issue","5"],["dc.bibliographiccitation.journal","Zeitschrift für Gastroenterologie"],["dc.bibliographiccitation.lastpage","418"],["dc.bibliographiccitation.volume","41"],["dc.contributor.author","Opitz, T."],["dc.contributor.author","Buchwald, Arnd B."],["dc.contributor.author","Lorf, Thomas"],["dc.contributor.author","Awuah, David"],["dc.contributor.author","Ramadori, Giuliano"],["dc.contributor.author","Nolte, W."],["dc.date.accessioned","2018-11-07T10:39:30Z"],["dc.date.available","2018-11-07T10:39:30Z"],["dc.date.issued","2003"],["dc.description.abstract","We present a 40-year-old female patient with epigastric pain, ascites, and progressive liver failure, caused by Budd-Chiari syndrome (BCS) with thrombotic occlusion of the right and middle hepatic veins. As underlying diseases, essential thrombocythemia and resistance to activated protein C (APC) due to heterozygote factor V Leiden were found. Initial therapy with heparin caused thrombocytopenia (HIT) type 11 culminating in thrombosis of the last patent left hepatic vein and further deterioration of liver function. The decision against a surgical shunt and liver transplantation by our surgeons on the basis of the risks involved, prompted us to insert a transjugular intrahepatic portosystemic stent-shunt (TIPS). There was no measurable flow signal in the doppler sonography of the portal vein presumably due to thrombosis. A further evaluation with magnetic resonance tomography and angiography was impossible due to movement artefacts. TIPS initially served as a diagnostic tool allowing direct angiography-diagnosed thrombosis of the portal vein, the superior mesenteric and the splenic vein respectively. However, insertion of the TIPS shunt and subsequent fragmentation led to an effective hepatic decompression and full recanalisation of the portal vein. In the present case TIPS simultaneously allowed the diagnosis of portal vein thrombosis and served as rescue therapy of complicated Budd-Chiari syndrome. The potential development of HIT type II should be kept in mind when heparin is given, especially to patients with thrombophilia."],["dc.identifier.isi","000183193200007"],["dc.identifier.pmid","12772054"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/46063"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","0044-2771"],["dc.title","The transjugular intrahepatic portosystemic stent-shunt (TIPS) as rescue therapy for complete Budd-Chiari syndrome and portal vein thrombosis"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dspace.entity.type","Publication"]]

[["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","461"],["dc.bibliographiccitation.issue","8"],["dc.bibliographiccitation.journal","Experimental and Clinical Endocrinology & Diabetes"],["dc.bibliographiccitation.lastpage","467"],["dc.bibliographiccitation.volume","116"],["dc.contributor.author","Raddatz, Dirk"],["dc.contributor.author","Nolte, W."],["dc.contributor.author","Rossbach, C."],["dc.contributor.author","Leonhardt, U."],["dc.contributor.author","Buchwald, A."],["dc.contributor.author","Scholz, Karl Heinrich"],["dc.contributor.author","Ramadori, Giuliano"],["dc.date.accessioned","2018-11-07T11:12:26Z"],["dc.date.available","2018-11-07T11:12:26Z"],["dc.date.issued","2008"],["dc.description.abstract","Background: Diabetes in liver cirrhosis is associated with a blunted insulin response, which might be explained by an impaired release of the incretin hormone glucagon-like peptide 1 (GLP-1) into the portal circulation. Aims: To investigate basal and stimulated portal venous and peripheral GLP-1 concentrations in non-diabetic (ND) and diabetic (D) patients with liver cirrhosis undergoing transjugular intrahepatic portosystemic stent shunt (TIPSS) implantation. Patients and Methods: After elective TIPSS portalvenous and peripheral probes were drawn from 10 ND and 10 D patients with stable liver disease during an oral metabolic test and plasma glucose, immunoreactive GLP-1, insulin and C-peptide were measured. Results: The study meal led to a significant rise in portal GLP-1 levels in ND and D. Basal and stimulated portal GLP-1 concentrations were not significantly different between ND and D. Peripheral GLP-1 did not differ significantly from portal venous levels. Insulin response in ND was more pronounced in the portal blood than in the periphery and was absent in D. Conclusion: TIPSS allows a direct evaluation of hormonal changes in the portal circulation during an oral metabolic tolerance test. A disturbed GLP-1 secretion does not play a role in blunting the insulin response observed in patients with hepatogenous diabetes."],["dc.identifier.doi","10.1055/s-2007-1004596"],["dc.identifier.isi","000259927300002"],["dc.identifier.pmid","18770489"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/53665"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Johann Ambrosius Barth Verlag Medizinverlage Heidelberg Gmbh"],["dc.relation.issn","0947-7349"],["dc.title","Measuring the effect of a study meal on portal concentrations of glucagon-like peptide 1 (GLP-1) in non diabetic and diabetic patients with liver cirrhosis: Transjugular intrahepatic portosystemic stent shunt (TIPSS) as a new method for metabolic measurements"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","107"],["dc.bibliographiccitation.issue","2"],["dc.bibliographiccitation.journal","Ultraschall in der Medizin - European Journal of Ultrasound"],["dc.bibliographiccitation.lastpage","112"],["dc.bibliographiccitation.volume","24"],["dc.contributor.author","Wietzke-Braun, Perdita"],["dc.contributor.author","Ritzel, U."],["dc.contributor.author","Nolte, W."],["dc.contributor.author","Leonhardt, U."],["dc.contributor.author","Armbrust, T."],["dc.contributor.author","Koc, Marcin"],["dc.contributor.author","Funke, M."],["dc.contributor.author","Grabbe, Eckhard"],["dc.contributor.author","Ramadori, Giuliano"],["dc.date.accessioned","2018-11-07T10:39:55Z"],["dc.date.available","2018-11-07T10:39:55Z"],["dc.date.issued","2003"],["dc.description.abstract","Aim: Therapeutic options for primary and secondary liver tumours not suitable for resection or transplantation are limited. In this palliative situation, the scope of ablative therapeutic procedures has improved. Laser interstitial thermotherapy is a minimal invasive procedure for local tumour destruction within solid organs. This pilot study reports initial clinical experience using ultrasound-guided percutaneous laser interstitial thermotherapy. Methods: Sixty patients between the ages of 34 and 78 years with non-resectable primary and secondary liver tumours were treated palliatively with Nd:YAG laser interstitial thermotherapy. High resolution abdominal ultrasound with power duplex was used to control the placement and coagulation procedure. Results: In all cases, sonographic imaging allowed exact placement of the laser probe and verification of thermocoagulation by a resulting hyperechogenic signal enhancement. The maximum diameter of laser-induced destruction measured 5 cm. Ultrasound with power duplex and echo enhancer, CT or MRI scans indicated necrosis of treated tumour lesions. No serious adverse event occurred and 30-day-mortality was zero. Conclusions: Ultrasound-guided laser interstitial thermotherapy is safe and reliably ablates primary and secondary liver tumours. The combination of high resolution ultrasound and laser therapy facilitates a minimally invasive but elaborate treatment. Besides chemotherapy, this procedure could be a useful palliative treatment to control the mass of liver tumours unsuitable for resection or transplantation."],["dc.identifier.doi","10.1055/s-2003-38664"],["dc.identifier.isi","000182484800006"],["dc.identifier.pmid","12698376"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/46171"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Georg Thieme Verlag Kg"],["dc.relation.issn","0172-4614"],["dc.title","Ultrasound-guided laser interstitial thermo therapy for treatment of non-resectable primary and secondary liver tumours - a feasibility study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","268"],["dc.bibliographiccitation.issue","5"],["dc.bibliographiccitation.journal","Experimental and Clinical Endocrinology & Diabetes"],["dc.bibliographiccitation.lastpage","274"],["dc.bibliographiccitation.volume","113"],["dc.contributor.author","Raddatz, Dirk"],["dc.contributor.author","Rossbach, C."],["dc.contributor.author","Buchwald, A."],["dc.contributor.author","Scholz, Karl Heinrich"],["dc.contributor.author","Ramadori, Giuliano"],["dc.contributor.author","Nolte, W."],["dc.date.accessioned","2018-11-07T11:03:20Z"],["dc.date.available","2018-11-07T11:03:20Z"],["dc.date.issued","2005"],["dc.description.abstract","Background: Hyperglucagonemia has been described to be associated with insulin resistance in patients with liver cirrhosis. Portosystemic shunts may be involved in the etiology of hyperglucagonemia. To test this hypothesis we investigated fasting peripheral plasma glucagon levels before and after portal decompression by transjugular intrahepatic portosystemic shunting (TIPS). Methods: Glucagon, insulin, plasma glucose, HbA1c, and C-peptide were determined in peripheral venous samples from 21 non-diabetic (ND)- and 15 diabetic patients (1); 3 treated with insulin, 3 with sulfonylurea, 9 with diet alone) with liver cirrhosis, showing comparable clinical features (gender, age, BMI, creatinine, Child-Pugh-score, complications, and etiology of liver cirrhosis) before, 3 and 9 months after elective TIPS implantation. insulin resistance was calculated as R-HOMA according to the homeostasis model assessment (HOMA). Results: Glucagon levels before TIPS were elevated in patients with diabetes compared to patients without diabetes (1): 145.4 &PLUSMN; 52.1 pg/ml vs. ND: 97.3 &PLUSMN; 49.8 pg/ml; p = 0.057). 3 and 9 months after TIPS implantation glucagon levels increased significantly in ND (188.9 &PLUSMN; 80.3 pg/ml and 187.2 &PLUSMN; 87.6 pg/ml) but not in D (169.6 &PLUSMN; 62.4 pg/ml and 171.9 &PLUSMN; 58.4 pg/ml). While plasma glucose, HbA1c, and C-peptide were significantly higher in D than in ND, they did not change significantly 3 and 9 months after TIPS implantation. Insulin was increased in D before TIPS (1): 31.6 &PLUSMN; 15.9 mU/l vs. ND: 14.8 &PLUSMN; 7.1 mU/l; p = 0.0001). 3 and 9 months after TIPS insulin significantly increased in ND (26.6 &PLUSMN; 14.7 mU/l and 23.2 &PLUSMN; 10.9 mU/l vs. 14.8 &PLUSMN; 7.1 mU/l before TIPS) but not in D. In ND R-HOMA also increased from 3.5 &PLUSMN; 2 mU x mmol/l(2) to 5.7 &PLUSMN; 3.3 mU x mmol/l(2) after 3 and 5.4 &PLUSMN; 2.6 mU x mmol/l(2) after 9 months. BMI, liver and kidney function did not change with time. Conclusion: In nondiabetic cirrhotic patients TIPS implantation is followed by an increase of glucagon. However, this does not result in a worsening of glycemic control, probably because of a simultaneous increase of insulin."],["dc.identifier.doi","10.1055/s-2005-837546"],["dc.identifier.isi","000229605500006"],["dc.identifier.pmid","15926112"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/51593"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Johann Ambrosius Barth Verlag Medizinverlage Heidelberg Gmbh"],["dc.relation.issn","0947-7349"],["dc.title","Fasting hyperglucagonemia in patients with transjugular intrahepatic portosystemic shunts (TIPS)"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["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"]]