Network


Latest external collaboration on country level. Dive into details by clicking on the dots.

Hotspot


Dive into the research topics where H. Rohde is active.

Publication


Featured researches published by H. Rohde.


Journal of Molecular Medicine | 1976

Histamine and peptic ulcer: a prospective study of mucosal histamine concentration in duodenal ulcer patients and in control subjects suffering from various gastrointestinal diseases

H. Troidl; W. Lorenz; H. Rohde; G. Häfner; M. Ronzheimer

ZusammenfassungIn einer prospektiven Studie wurde der Histamingehalt der Korpusschleimhaut bei 100 Patienten gemessen. Diese Patienten schließen Kontrollpersonen, Ulkus-duodeni-Träger und solche mit verschiedenen gastrointestinalen Erkrankungen ein. Der Histamingehalt betrug 43 µg/g bei Kontrollpersonen und war bei Ulkus-duodeni-Kranken signifikant um 30% erniedrigt. Alle anderen Patientengruppen wiesen „normale“ Histamingehalte in der Magenschleimhaut auf. Da es bei allen Säugerarten mit Ausnahme der Ratte äußerst schwierig ist, den Histamingehalt der Magenschleimhaut durch irgendeine Maßnahme zu verändern, erscheint die Abnahme des Histamingehaltes der Korpusschleimhaut beim Ulkus duodeni besonders bemerkenswert. Unter verschiedenen Hypothesen gilt als wahrscheinlichste eine vermehrte Histaminfreisetzung beim chronischen Ulkus duodeni.SummaryIn a prospective study the histamine content of the mucosa of the body of the stomach was measured in 100 patients consisting of control subjects, patients with duodenal ulcer and patients suffering from various gastrointestinal diseases. The histamine content was found to be 43 µg/g in male control subjects (median) while in duodenal ulcer patients levels attained were significantly lower by about 30 per cent. In all the other groups of patients histamine concentrations in gastric mucosa were found to be “normal”. Since in most species it is extremely difficult to alter the mucosal histamine concentration by any form of treatment, the diminished histamine content of the gastric mucosa in patients with duodenal ulcer seems remarkable. Among several possible explanations offered for this finding we think the most likely is that histamine release is increased in duodenal ulcer disease.


Journal of Molecular Medicine | 1977

[Systematic follow-up: a concept for evaluation of operative results in duodenal ulcer patients].

H. Rohde; H. Troidl; W. Lorenz

ZusammenfassungIn einigen gastroenterologischen Zentren wurde für Patienten mit chronischem Ulcus duodeni das Konzept einer systematischen Kontrolluntersuchung entwickelt, bei der definierte Merkmale und Parameter vor und in bestimmten zeitlichen Intervallen nach der Operation erhoben wurden. Ihre Notwendigkeit läßt sich mit zahlreichen Argumenten beweisen und ihre Organisationsstruktur muß sorgfältig von einer unregelmäßig nach der Operation stattfindenden Nachuntersuchung unterschieden werden. Die systematische Kontrolluntersuchung liefert eine logische Grundlage für die Behandlung von Patienten, die nicht auf Erfahrungen aus persönhchen Eindrücken beruht. Die Technik bei Erhebung von Befunden in einer solchen systematischen Kontrolluntersuchung wirft viele Teilfragen auf, die in verschiedenen Zentren unterschiedlich beantwortet werden können, auf jeden Fall aber durch kontrollierte klinische Studien getestet werden müssen. Alle diese Bemühungen haben aber das Ziel, klinische Daten mit größerer Zuverlässigkeit und mit weniger persönlichem Vorurteil zu ermitteln als bisher. Es wird ein Konzept für die Erhebung von Operationsresultaten bei Patienten mit chronischem Ulcus duodeni dargestellt, wie es in Marburg durchgeführt wird. Die Befunde werden durch eine Serie von standardisierten Interviews und Untersuchungen erhoben. Die Diagnose, Indikation für die Operation und das Operationsresultat werden abschließend durch ein Rundtischgespräch von Experten ermittelt. Welche Rolle der theoretische Chirurg bei der systematischen Kontrolluntersuchung übernehmen kann, wird dargestellt. Schließlich wird die Anwendung dieses Prinzips sowohl für die Universitätskliniken als auch für Stadt-und Kreiskrankenhäuser empfohlen.SummaryFor patients with chronic duodenal ulcer a systematic follow-up concept has been developed in several medical centers. Defined attributes and parameters are assessed in each of the patients before, and at several intervals after, operation. The necessity of such a follow-up can be defended on several grounds and by its organisational structure it can be differentiated from a simple and irregular medical check-up after operation. It provides a more rational basis for treating a patient than the “experience” made up by impressions. The question of logistics in such a gastric follow-up contains many subquestions which may be answered differently in different locations but have still to be tested by controlled clinical trials. All these considerations however have the common aim to assess clinical data more reliably and with less personal bias than before.A concept for the evaluation of operative results in duodenal ulcer patients as has been started in Marburg is presented. Findings are obtained by a series of standardized interviews and examinations. Diagnoses, indications for operation and results of operation are established by a final decision made by a panel. A role for a theoretical surgeon in the follow-up is proposed. The possibility of performing a gastric follow-up is advocated both for University and district hospitals.


Inflammation Research | 1977

Histamine and peptic ulcer disease: Histamine methyltransferase activity in gastric mucosa of control subjects and duodenal ulcer patients before and after surgical treatment

H. Barth; H. Troidl; W. Lorenz; H. Rohde; R. Glass

Histamine methyltransferase (HMT) activity was determined by a modified isotope assay in biopsy specimens from gastric mucosa of control subjects, duodenal ulcer patients and after various gastric operations.Enzymic activity of male control subjects who were ‘healthy’ with respect to their upper gastrointestinal tract was 70.4±12.8 pmol/(min×mg protein). In male duodenal ulcer patients HMT-activity was significantly lowered by 15%; following selective vagotomy with pyloroplasty a significant increase of 14% was observed as compared to controls. The difference between values before (59.9±13.3) and after (80.4±11.7) this operation was highly significant (p<0.001). Experiments in a small number of patients showed that after other modifications of vagotomy elevated HMT-activities were also found, whereas after resection procedures such changes of enzymic activity did not occur.According to these results the low gastric HMT-activity of duodenal ulcer patients could play a role in the pathogenesis of a chronic peptic ulcer by being responsible for reduced histamine inactivation and — as a consequence —enhanced acid secretion. Furthermore, vagotomy seemed to influence acid secretion in human subjects not only by direct effects on the parietal cells, but also by an activation of histamine catabolism. One patient, who despite complete vagotomy showed both no reduction in acid secretion and a low gastric HMT-activity, may be the representative of a new population of peptic ulcer patients.


Journal of Molecular Medicine | 1973

Eine prospektive, kontrollierte Studie zur selektiven Vagotomie beim chronischen Duodenalulkus: Frühergebnisse mit einer standardisierten Operationsauswahl und Operationstechnik

W. Seidel; H. Troidl; W. Lorenz; H. Rohde; H. Richter; H. Drews; H. Hamelmann

SummaryA prospective, controlled study on a standardized selection procedure of patients for the surgical treatment and on a standardized operation technique of selective vagotomy was carried out with 65 patients suffering from chronical uncomplicated or complicated duodenal ulcer. The operation technique, the aim, preparation and performance of the study, the designation of operators and investigators for the follow-up, the selection of patients for surgical treatment as well as the methods for measuring pre- and postoperatively various clinical and clinical chemical parameters are described in detail.The first follow-up was performed 6 to 12 months following surgical treatment in 60 patients. 4 patients died in the meantime, 1 patient could not be controlled because of an unknown new address. The operative mortality was 0%, intraoperative and postoperative complications were observed in 2 and 15% of the patients, whereas recurrent ulcers were found in 2 cases. The overall assessment of the clinical condition according to a modified classification of Visick was good in 85% and satisfactory in 93% of the patients. Mild diarrhoea was observed in 8%, severe diarrhoea in none and mild dumping in 30% of the patients. Positive insulin tests according to the criteria of Hollander were observed in 27% of the cases, but only in 7% were there early positive tests according to Ross and Kay. Depending on the drainage procedure, the basal secretion was reduced by 83–98%, the pentagastrin stimulated maximum secretion by 51–95%.This prospective controlled study was a preliminary investigation completed by another trial, in which two operative techniques for the treatment of chronical duodenal ulcer will be compared. The early results of our study, however, are in favour of the concept of an individually adapted treatment with selective vagotomy in duodenal ulcer.ZusammenfassungEine prospektive, kontrollierte Studie über eine standardisierte Operationsauswahl und Operationstechnik der selektiven Vagotomie wurde an 65 Patienten mit kompliziertem und unkompliziertem chronischem Duodenalulcus durchgeführt. Operationstechnik, Ziel, Vorbereitung und Durchführung der Studie, Operateure und Nachuntersucher, Patientenauswahl und die Methoden der Nachuntersuchung werden im Detail beschrieben.In einem Zeitraum von 6–12 Monaten postoperativ wurden 60 Patienten nachuntersucht, 4 Patienten waren verstorben, 1 Patient nicht auffindbar. Die operative Letalität betrug 0%, intra- und postoperative Komplikationen wurden bei 2 bzw. 15% der Patienten beobachtet, 2 Rezidive wurden festgestellt. Das klinische Allgemeinbefinden war bei 85% der Patienten gut, bei 93% befriedigend. Leichte Diarrhoen wurden bei 8%, schwere in keinem Fall beobachtet. Dumping trat dagegen in 30% der Fälle auf, war aber immer nur geringfügig. Positive Insulinteste nach verschärften Hollander-Kriterien wurden in 27% der Fälle gefunden. Die Basalsekretion wurde um 83–98% reduziert, die mit Pentagastrin maximal stimulierte Sekretion um 51% nach Vagotomie und Pyloroplastik, um 87% nach Vagotomie und distaler Antrektomie (BI) und um 95% nach Vagotomie und Antrektomie (BII).Die vorgelegte prospektive Studie stellt den ersten Teil einer Untersuchung dar, die zur Beurteilung verschiedener Vagotomieformen in der chirurgischen Therapie des chronischen Duodenalulcus herangezogen werden soll. Die Frühergebnisse dieser Studie rechtfertigen aber vorläufig die Empfehlung einer individuellen Anwendung der selektiven Vagotomie in Kombination mit Drainageoperation oder Antrektomie.


Journal of Molecular Medicine | 1980

Histamine and stress ulcer: new components in organizing a sequential trial on cimetidine prophylaxis in seriously ill patients and definition of a special group at risk (severe polytrauma)

W. Lorenz; M. Fischer; H. Rohde; H. Troidl; H. J. Reimann; Ch. Ohmann

ZusammenfassungBei 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.SummaryIn 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 Fishers 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.


Inflammation Research | 1973

Augmentation of pentagastrin stimulated gastric secretion in the Heidenhain pouch dog by amodiaquine: inhibition of histamine methyltransferase in vivo?

H. Troidl; W. Lorenz; H. Barth; H. Rohde; G. Feifel; A. Schmal; K. Goecke; A. Reimann-Huhnd; W. Seidel

In 9 dogs, whose maximum gastric acid response to pentagastrin was evoked by 6 μg/kg, the total gastric secretion as well as the peak gastric secretion was enhanced by amodiaquine. The optimum dose of this antimalarial drug was 2 mg/kg, whereas 0.25 mg/kg were without effect and 3 mg/kg reduced already the augmentation of gastric secretion by this substance. The increase in acid output by amodiaquine was greater than that in volume. The total secretion was more enhanced than the peak secretion, which means a longer duration of the amodiaquine potentiated gastric secretion elicited by pentagastrin, than that without application of amodiaquine contrary to that stimulated by exogenous histamine.Amodiaquine itself did not stimulate gastric acid secretion, in contrast to prostigmine and carbachol. Thus amodiaquine seemed not to enhance gastric secretion by a direct or indirect parasympathomimetic action. The question whether amodiaquine acted on gastric secretion in a specific way and not by parasympathomimetic effects, led to investigations in several exocrine glands. In salivary glands, amodiaquine did neither stimulate the secretion in all doses investigated nor did it enhance the pilocarpine and acetylcholine induced salivation with any significance and regularity. Also the pancreatic and biliary secretion was neither stimulated by amodiaquine nor was the secretin induced secretion of the pancreas and liver augmented by amodiaquine. Thus the enhancing effect of this drug on the histamine and pentagastrin stimulated gastric secretion was very likely specific for the gastric mucosa and not due to a parasympathomimetic action of the drug.In contrast to the findings in various exocrine glands of the gastrointestinal tract, the arterial hypotension following the i.v. injection of acetylcholine was increased specifically by a preceeding i.v. injection of amodiaquine, whereas the equi-effective actions of histamine, serotonin and bradykinin as well as the hypertension by epinephrine and norepinephrine were not influenced by amodiaquine. This specific effect of the antimalarial drug very probably was not caused by an inhibition of the unspecific choline esterase in the blood.Since in exocrine glands no evidence could be found for a parasympathomimetic action or other modes of action of amodiaquine, it seemed probable that amodiaquine potentiated the histamine and pentagastrin stimulated gastric secretion by an inhibition of histamine methyltransferase in vivo.


Inflammation Research | 1980

Histamine and peptic ulcer: Influence of sample-taking on the precision and accuracy of fluorometric histamine assay in biopsies of human gastric mucosa

H. Rohde; W. Lorenz; H. Troidl; H. J. Reimann; G. Häfner; D. Weber

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.


Journal of Molecular Medicine | 1979

Prospektive, kontrollierte Studien in der Chirurgie. Kontroverse Standpunkte zur Motivierung und Durchführung [Prospective controlled clinical trials in surgery. Controversial issues in motivation and performance (author's transl)]

W. Lorenz; H. Rohde

SummaryControversial aspects in prospective controlled trials in surgery can be detected at various stages in the course of this research work, such as in motivation, planning and performance as well as in assessment and evaluation of the results. Especially the introduction of control groups, randomization and “blindness” of patients, operators and doctors running the follow-up are subjects of a controversial discussion. Subthreshold arguments for defenders and deniers of the trial are taken from different theories of science, such as empirism and rationalism which are more effective in the daily routine work than expected.Provided that convincingly only therapeutic and diagnostic procedures are compared which were considered as equi-effective and reliable to the same extent according to the best and most complete knowledge available it is ethically justified to perform controlled randomized trials. It should, however, not be expected that they (always) produce differences between treatments of high degree of difference. The aim of the controlled trials is not the introduction of sensational novelties into medicine, but the abolition and prevention of unnecessary and unworthy modes.ZusammenfassungKontroverse Standpunkte zu prospektiven, kontrollierten Studien in der Chirurgie gibt es bei der Motivierung, Planung und Durchführung sowie bei der Auswertung dieser klinischen Forschungsarbeiten. Im besonderen werden die Bildung von Vergleichsgruppen, die Randomisierung und die Blindheit von Patient, Operateur und Untersucher diskutiert. Unterschwellig spielen bei Befürwortern und Gegnern erkenntnistheoretische Gesichtspunkte eine Rolle, die mehr die ärztliche Praxis beeinflussen, als im Alltag offenkundig wird.Unter der Voraussetzung, daß in überzeugender Weise nur therapeutische oder diagnostische Verfahren miteinander verglichen werden, die nach bestem Wissen und Gewissen als gleich wirksam oder gleich zuverlässig angesehen werden, sind prospektive kontrollierte, randomisierte Studien als ethisch voll gerechtfertigt anzusehen. Man darf aber auch dann von ihnen nicht erwarten, daß sie hochgradige Unterschiede zwischen den Verfahren zutage fördern. Ihr Ziel ist es nicht, sensationelle Neuheiten in die Medizin einzuführen, sondern in erster Linie unnötige und wertlose Moden auszumerzen und zu verhindern.


Inflammation Research | 1982

Assay and identification of histamine in human gastric aspirate by a fluorometric-fluoroenzymatic technique. Its application in patients with chronic duodenal ulcer

J. V. Parkin; W. Lorenz; H. Barth; H. Rohde; Ch. Ohmann; K. Thon; D. Weber; M. Crombach

Histamine assays can be unreliable in individual subjects or samples even though the particular method is in general working very well. Therefore the specificity and accuracy of histamine determination in the gastric aspirate of individual duodenal ulcer patients was thoroughly examined and shown to be satisfactory.Pitfalls of the fluorometric assay were investigated. A native (non-histamine) fluorescence in gastric aspirate which occurs before the addition of OPT was not removed by the original Shore procedure. In the combined assay (Dowex 50+ butanol extraction) this fluorescence no longer interferes with the assay.For the identification of histamine in a single gastric aspirate of an individual duodenal ulcer patient, the reversed blank (3M HCl added to the reaction mixture before OPT instead after OPT), excitation and fluorescence spectra, the heating test with spectra recorded and the HMT test were found to be reliable. The formaldehyde test and the heating test without recording the spectra were useless since they gave false negative results. Since the HMT test was regarded as a reference method it was thoroughly investigated both by theoretical considerations (enzyme kinetics) and by a series of measurements in a single patient as well as in a group of nine subjects.Samples from the period of peak acid output in response to pentagastrin showed an average histamine concentration of about 8 ng/ml and a histamine output of 1.5 μg/30 min.


Journal of Molecular Medicine | 1973

Probleme bei der Durchführung einer prospektiven, kontrollierten Studie über chirurgische Behandlungsmethoden

W. Lorenz; H. Rohde

Problenvs in the Per]ormance el Prospective Controlled Trials about Surgical Treatment Procedures. In zunehmendem MaBe setzt sieh in der ehirurgischen Forsehung die Uberzeugung durch, dag die Bewertung und der Vergleich chirurgiseher Verfahren h/~ufig nieht durch retrospektive Effahrungsberiehte, sondern dutch prospektive, kontrollierte und bei Operationsvergleiehen auch durch randomisierte Studien durchgeffihrt werden mu

Collaboration


Dive into the H. Rohde's collaboration.

Top Co-Authors

Avatar

W. Lorenz

University of Marburg

View shared research outputs
Top Co-Authors

Avatar

H. Troidl

University of Marburg

View shared research outputs
Top Co-Authors

Avatar

K. Thon

University of Marburg

View shared research outputs
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar

H. Barth

University of Marburg

View shared research outputs
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar

D. Weber

University of Marburg

View shared research outputs
Researchain Logo
Decentralizing Knowledge