Biomedical subjects

B Wedmann

Publications and source records attributed to B Wedmann.

At least 19 recordsLinked to original sources

PubMed1996

[Does chronic alcohol drinking modify digestive gastrobiliary motility?].

In 23 chronic alcoholics and 23 controls gastric emptying, antral motility, fasting gallbladder volume and gallbladder emptying after a standardized, liquid fatty meal were investigated ultrasonically in order to assess the effect of chronic alcoholism on postprandial gastrobiliary motility. Only a subgroup of the alcoholics with signs of autonomic cardiovascular neuropathy (21.7%) exhibited a significant antral hypomotility and a tendency towards higher fasting gallbladder volumes. No significant differences between the study groups could be obtained for the other parameters. The duration and daily amounts of alcohol consumption were not significant different between patients with autonomic neuropathy and patients without autonomic neuropathy. Within the whole group of alcohol consumers the only significant correlation that was observed occurred between the fat induced gallbladder residual volumes and the amounts of daily alcohol consumption (r = 0.62, p < 0.05). However 19 of these 23 relative gallbladder residual volumes were within the normal range (95. percentile of the control group), indicating no major clinical relevance of this phenomenon. None of the motility parameters exhibited a significant correlation to the duration of alcohol consumption. From these results chronic alcohol consumption has no irreversible effects of clinical relevance on the postprandial gastrobiliary motility in the majority of patients in contrast to well documented reversible effects of acute alcohol consumption on gastric motility.

Adult↗

PubMed1995

[Ultrasound detection of gastric antrum motility--evaluating a simple semiquantitative method].

AIM: This study was carried out to evaluate a simplified sonographic technique for the sonographic analysis of antral motility. METHOD: For this purpose the percentage of visually complete contractions (estimated reduction of the antral area > 50%)/2 minutes was compared to the mean amplitude (%) and the mean velocity (%/s) of the contractions. RESULTS: The percentage of complete contractions was closely correlated to both the mean amplitude (r = 0.97, p < 0.0001) and the velocity (r = 0.92, p < 0.0001) of the antral contractions. CONCLUSION: Since the simplified technique is regardless to a postprocessing unit, which is not available in many sonolayers, it could be recommended as a valid routine screening method for the detection of antral motility disorders.

Adult↗

PubMed1995

[Intraindividual reproducibility of ultrasound detection of gastrobiliary motility parameters and CCK incretion after a standardized, liquid, fat-containing test meal].

AIM AND METHODS: Gastric emptying, antral mobility, fasting gallbladder volumes, gallbladder emptying rates, and CCK incretion following a standardized liquid fatty meal were investigated in 14 healthy young volunteers (seven women and seven men) on two separate study days. In the seven young women, taking oral contraceptives, one study day was in the oestrogen phase and the other in the gestagen phase of their menstrual cycle. RESULTS: There was good intraindividual reproducibility of the different sonographic gastrobillary motility parameters and the postprandial CCK incretion in both sexes (coefficients of reliability between 0.80 and 0.98). A significant effect of the menstrual cycle phase in young women was not evident. Instead of this a wide interindividual range of motility parameters, especially of gastric residual volumes in young women, could be obtained. There was no close correlation between gastric emptying rates or the amounts of the fat induced cholecystokinin incretion and gallbladder emptying rates, indicating the relevance of additional cholecystokinin-independent preduodenal mechanism for the regulation of physiological digestive gallbladder emptying.

Adult↗

PubMed1995

The significance of electrogastrographically determined amplitudes--is there a correlation to sonographically measured antral mechanical contractions?

Cutaneous electrogastrography (EGG) allows the measurement of gastric electrical activity. An association of EGG with gastrointestinal motility disorders has been shown. Abnormalities of electrical rate or rhythm are accepted as the most important parameters in EGG. However, the reliability of the magnitude of electrical amplitude in the assessment of motility is discussed controversially. Therefore in a prospective study we investigated the relation between amplitude and antral contractions by means of ultrasonography. 8 healthy volunteers (4 men, 4 women, 24-31 years) ingested 400 ml carbonated mineral water after an overnight fast at two separate study days. Over a period of 10 min preprandial and 10 min postprandial small and intense antral contractions were measured employing sagittal antral planimetry. Simultaneous amplitudes were determined during contractions and at 1 min intervals (average amplitude) by cutaneous electrogastrography. Data were analyzed by Wilcoxon's rank sum test and Spearman rank correlation test. The coefficient of variation of the postprandial/preprandial amplitude ratio was nearly two times greater between subjects than between recordings in the same subject, which reflects a moderate intraindividual reproducibility. We found a significant increase in the average amplitude postprandially (p < 0.05). Although postprandial contractions (n = 243) predominated preprandial contractions (n = 127) significantly (p = 0.02), no significant correlation between the number of contractions and the average amplitude existed (R = 0.1; p = 0.7). Moreover the average amplitude did not differ from amplitudes during intense and small contractions significantly (p = 0.7; p = 0.1). The magnitude of the amplitude measured by EGG does not correlate with the mechanical gastral activity significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

[Endoscopic diagnosis of colonic tuberculosis].

A 67-year-old woman had developed weakness, fatigue and a 10 kg weight loss over the past year. On examination a cylindrical mass was palpated in the right middle abdominal cavity. Erythrocyte sedimentation rate was increased to 87/126 mm, there was an hypochromic anaemia (haemoglobin 9.1 mg/dl) and an hypoalbuminaemia (32 g/l) with an increase in alpha 2-globulins (9.4 g/l), Cholinesterase activity was decreased to 588 U/l. X-ray film of the abdomen revealed a calcified mesenteric lymph-node and coloscopy demonstrated polypoid tumorous changes with ulcerations, extending from the pole of the caecum to the right flexure. Histological examination showed epithelioid-cell granulomas with Langhans giant cells. Culture grew Mycobacterium tuberculosis, confirming the diagnosis of intestinal tuberculosis. She was treated with oral doses of isoniazid (300 mg daily), rifampicin (600 mg daily) and pyrazinamide (2 g daily) for 2 months, followed by isoniazid and rifampicin for a further 4 months. After this the laboratory tests were within normal limits and urine as well as stool samples contained no acid-fast bacilli. As the patient felt so well she declined another coloscopy.

Aged↗

PubMed1994

Gastrobiliary motility after liquid fatty meal in progressive systemic sclerosis. A sonographic study.

Gastric emptying, antral motility, and gallbladder emptying after a liquid fatty meal were studied by ultrasound in 25 patients with progressive systemic sclerosis and in 25 sex- and age-matched controls. In patients with systemic sclerosis, the possible role of autonomic dysfunction was evaluated by four noninvasive cardiovascular reflex tests. Despite a significant delay of gastric emptying and a significant postprandial antral hypomotility in the patients with systemic sclerosis, the fat-induced gallbladder emptying was only slightly reduced, reaching no significant level when compared to the controls. The prolongation of gastric emptying correlated significantly with the duration of the disease. Although 36% of the patients in the systemic sclerosis group exhibited signs of autonomic cardiac dysfunction, there was no evidence of an association between these signs and gastric motor dysfunction. In conclusion motility disorders of the gallbladder seem to play a minor role in the upper gut involvement of systemic sclerosis, whereas motility disorders of the stomach are frequent and can be easily recognized noninvasively by real-time ultrasound.

Adult↗

PubMed1994

Gastrointestinal transit through esophagus, stomach, small and large intestine in patients with progressive systemic sclerosis.

Liquid esophageal transit and gastric emptying, mouth-to-cecum transit, and whole gut transit of a solid-liquid meal were measured in 14 patients with PSS, 16 control subjects (esophageal transit), and 20 control subjects (gastrointestinal transit), respectively, by using scintigraphic techniques, the hydrogen breath test, and stool markers. In patients with PSS, the glucose hydrogen breath test for detection of small intestinal overgrowth was performed and various gastrointestinal symptoms were determined. Esophageal transit and gastric emptying were significantly prolonged in PSS patients with 11 of 14 PSS patients (79%) disclosing delayed esophageal transit and eight of 14 PSS patients (57%) disclosing delayed gastric emptying. All PSS patients with prolonged gastric emptying also had delayed esophageal transit and there was a significant positive correlation between esophageal transit and gastric emptying (r = 0.696, P < 0.01). No significant differences between PSS patients and controls were detected concerning mouth-to-cecum transit and whole gut transit, but abnormally delayed mouth-to-cecum transit was found in four of 10 PSS patients (40%) and abnormally prolonged whole gut transit was detected in three of 13 PSS patients (23%). Small bacterial overgrowth was diagnosed in three of 14 PSS patients (21%). Delayed esophageal transit and gastric emptying were associated with dysphagia, retrosternal pain, and epigastric fullness, while prolonged whole gut transit was associated with constipation. It is concluded that delayed gastric emptying is frequently associated with esophageal transit disorders in PSS patients and may be one important factor for the development of gastroesophageal reflux disease in these patients.

Adult↗

PubMed1994

[Ultrasound measurement of gastric emptying of a solid test meal. Correlation with scintigraphy in diabetic patients and reproducibility in healthy probands].

Measurement of gastric emptying of liquids by sagittal antral planimetry is established. Ultrasonic measurement of gastric emptying of solids has not been assessed although gastroparesis often reveals a delayed gastric emptying of solids first. Therefore in this prospective study we used a solid meal (50 g rye bread, 1 egg, 40 g butter, 200 ml orange juice; 280 kcal) to examine intraindividual reproducibility of ultrasound in 20 healthy volunteers. Moreover, in 20 diabetics antral planimetry assessed by ultrasound was compared to scintigraphy. Antral planimetry showed a coefficient of variation, that was nearly three times greater between subjects than between two measurements performed on the same subject. This results reflect a good intraindividual reproducibility. Gastric emptying half-times assessed by ultrasound and scintigraphy did not correlate in diabetics (R = 0.2). However, correlation between sonographic measurement of antral area and scintigraphy at defined times (60, 120, 180, 240 min) was significant (R = 0.7; p < 0.001). These results imply that ultrasonic antral planimetry is a suitable orientating method for measuring gastric emptying of solids.

Adult↗

PubMed1994

Endosonographically guided fine-needle aspiration puncture of paraesophagogastric mass lesions: preliminary results.

Mass lesions adjacent to the gastroesophageal wall can be visualized in detail by endoscopic ultrasonography. However, in many patients tissue diagnosis of these mass lesions is urgently required. We evaluated the efficiency of transmural fine-needle aspiration puncture guided by endosonography for cytological confirmation of such mass lesions. Endosonographically guided transmural fine-needle aspiration (EUS-guided FNA) puncture was performed in 12 patients with extrinsic mass lesions adjacent to the gastro-esophageal wall. In seven patients a malignant tumor and in four patients a benign lesion, were identified by EUS-guided FNA puncture, while in one patient no diagnostic tissue specimen could be obtained. No complications were observed. The cytological result of a malignant lesion was confirmed in six patients either by autopsy (n = 3), resection of tumor metastasis (n = 1) or by demonstration of a local recurrence of a previously histopathologically diagnosed carcinoma (n = 2), while the benign cytological results in four patients were confirmed by a follow-up period of at least 13 months (n = 3) and appropriate diagnostic tests (n = 1). It is concluded that EUS-guided FNA puncture is an efficient diagnostic technique for the assessment of malignancy and tissue diagnosis of extrinsic paragastroesophageal mass lesions. An important precondition for the successful performance of transmural EUS-guided FNA puncture is the application of endosonographic transducers with longitudinal scanning in the axis of the endoscope.

Aged↗

PubMed1993

[Severe backache in clinically inactive ulcerative colitis].

A 22-year-old man with a history of ulcerative colitis complained of progressive lower back pain that had persisted for more than one year and which finally confined him to bed. X-ray examination revealed sclerosis of the right sacroiliac joint, and of the 6th lumbar vertebra. An NMR examination revealed a diffuse signal loss in the region of the 6th lumbar vertebra. On account of the progressive increase in liver transaminases in the serum, an ERCP was carried out, which confirmed the suspected primary sclerosing cholangitis (PSC). Severe axial arthritis and PSC with underlying clinically inactive ulcerative colitis was diagnosed, and treatment with salazosulfapyridine and ursodeoxycholic acid initiated. This led to freedom from pain within a matter of weeks and an appreciable reduction in serum cholestasis parameters.

Adult↗

PubMed1993

[Cerebral vasculitis in Crohn disease].

Central nervous system vasculitis in Crohn's disease. A 36-years old man was referred to the hospital because of severe headache, vertigo and right sided combined motor-sensory hemiparesis. There was a history of Crohn's disease with an acute exacerbation only two months ago. Magnetic resonance imaging detected a vascular lesion of the left brainstem and serologic investigations revealed circulating immunocomplexes and p-antineutrophil cytoplasmic autoantibodies (p-ANCA). Further investigations care no evidence of arteriosclerotic cerebrovascular disease. These findings therefore suggest that cerebral vasculitis secondary to Crohn's disease was the underlying cause of this focal neurologic deficit.

Adult↗

PubMed1992

[Endosonographically directed transesophageal fine needle aspiration in diagnosis of mediastinal para-esophageal space-occupying processes].

Endoscopic ultrasonography with high-frequency ultrasonic beams allows detailed study of the gastrointestinal wall structures and the surrounding Tissues. Moreover most echoendoscopes carry a biopsy channel for biopsy or cytologic puncture guided by endoscopic ultrasonography. We present a patient with a tumor in the posterior mediastinum in whom conventional diagnostic techniques failed to obtain speciments for cytologic evaluation. Transesophageal fine needle aspiration guided by endoscopic ultrasonography confirmed the diagnosis of lung cancer consisting of adeno and small cells in this patient. Transesophageal fine needle puncture guided by endoscopic ultrasonography might become a valuable aid for the diagnosis of tumor masses in the posterior mediastinum.

Aged↗

PubMed1992

Effect of hyperthyroidism on the transit of a caloric solid-liquid meal through the stomach, the small intestine, and the colon in man.

Gastric emptying, mouth-to-cecum transit, and whole gut transit of a solid-liquid meal was measured in 20 hyperthyroid patients and in 30 control subjects by using scintigraphic techniques, the hydrogen breath test, and stool markers. In the hyperthyroid patients predefined gastrointestinal symptoms were determined and related to gastrointestinal transit. There was no significant overall difference of gastric emptying between the hyperthyroid patients and the control subjects, whereas both mouth-to-cecum transit time (mainly reflecting small intestinal transit) and whole gut transit time (mainly reflecting large intestinal transit) were significantly accelerated in hyperthyroid patients as compared to the control subjects (P less than 0.005). Mouth-to-cecum transit in hyperthyroid patients with diarrhea tended to be more rapid than in those without diarrhea (P = 0.094) and the T3 concentrations were inversely correlated with mouth-to-cecum transit time. It is concluded that in thyrotoxicosis 1) small and large intestinal transit is accelerated, while gastric emptying remains unchanged and 2) rapid intestinal transit is likely to be one factor among others implicated in the generation of diarrhea.

Adult↗

PubMed1992

[Gallbladder motility in diabetic patients with and without cardiovascular neuropathy].

In 50 diabetic patients without gallstones, including 26 patients with cardiovascular autonomic dysfunction, and 60 normal volunteers the fasting volume and volume reduction of the gallbladder after a liquid fatty meal were determined ultrasonically in intervals of ten minutes up to one hour. Simultaneously the gastric emptying of the liquid meal was followed by ultrasound imaging. Despite an association of other complications of diabetic disease (peripheral neuropathy, retinopathy) with autonomic cardiovascular dysfunction, an altered gallbladder resting volume or impaired fat-induced volume reduction was not evident in this group of patients when compared the diabetics without cardiovascular dysfunction or controls. The time to reach the minimal residual gallbladder volume was only tendentiously prolonged in diabetics with autonomic cardiovascular dysfunction. The residual volume of the stomach showed no significant difference between the three study groups using a liquid test meal. In conclusion neuropathic dysfunction of the gallbladder is unlikely to play a major pathogenetic role in the development of gallstones in diabetic patients.

Adult↗

PubMed1992

Does physical exercise influence bowel transit time in healthy young men?

An examination was performed on 20 healthy men, who had a specific diet, to test the influence of moderate physical activity on bowel transit. During a 3-day pause and a 3-day phase of easy sports activity (jogging), oro-anal transit was measured with the help of radiopaque markers (Hinton method). While the subject was under exertion, the entire weight of stool rose significantly (743 vs. 600 g), whereas we found no significant influence on the oro-anal transit time (39 vs. 48 h) or on stool frequency (1.3 vs. 1.3 per day). Moderate physical activity had no effect on bowel transit time of healthy men under a constant diet. The effect of the so often recommended increase of physical activity on constipation remains to be elucidated.

Adult↗

PubMed1991

[Diagnostic value of ultrasonographic testing of the gallbladder function in cholelithiasis].

Decrease in gall-bladder volume after intake of a test meal was assessed by ultrasound in 30 patients (24 females, 6 males; mean age 55 [22-82] years) with indications for elective or early elective cholecystectomy for cholelithiasis. Patients were assigned to three groups, based on intraoperative and histological gall-bladder changes: group 1 (n = 17), without changes or with mild chronic cholecystitis; group 2 (n = 4), with severe chronic inflammatory changes; group 3 (n = 9), with acute cholecystitis or cystic duct occlusion. A volume decrease of at least 30% after the test meal excluded only acute wall inflammation (negative predictive value 95.5%), while a volume reduction of at least 50% made it possible in a high percentage of cases (negative predictive value 88.2%) to predict correctly an absence of severe chronic wall changes. Before organ-preserving treatment (extracorporeal lithotripsy or local litholysis) is undertaken, gall-bladder volume reduction of at least 50% should be documented.

Acute Disease↗

PubMed1991

[Carcinoembryonic antigen (CEA) in ascites].

The diagnostic value of carcinoembryonic antigen (CEA) was studied prospectively in 18 patients with ascites of malignant and 28 patients with ascites of benign genesis. Both sensitivity and specificity reached 83%. With a prevalence of malignant disease of 38%, the positive and negative predictive values were 75% and 89%, respectively. In contrast to frequent false-positive CEA values in the serum of liver cirrhotics (48.3%), false-positive CEA values in the ascites of the same patients were observed in only 17.3%. It is thus recommended that if CEA determination is to be employed, it should be done in the ascites itself.

Ascites↗

PubMed1991

Gastrointestinal transit of solid-liquid meal in chronic alcoholics.

Gastric emptying, mouth-to-cecum transit, and whole-gut transit of a solid-liquid meal were measured in 46 chronic alcoholics and in 30 control subjects by using scintigraphic techniques, hydrogen breath test, and stool markers. In the alcoholics various parameters such as ethanol consumption, gastrointestinal symptoms, and alcoholic neuropathy were determined and related to gastrointestinal transit times. Although there was no significant overall difference of gastric emptying, abnormally delayed gastric emptying was detected in 23.9% of the alcoholics but no control subject (P less than 0.005). Mouth-to-cecum transit was significantly prolonged in the alcoholics (P less than 0.001) with 14 alcoholics (37.8%) disclosing delayed mouth-to-cecum transit. No significant differences between both groups were detected concerning whole gut transit. In the alcoholics there was a significant correlation of dyspeptic symptoms with delayed gastric emptying (P less than 0.006), and alcoholics with diarrhea had an accelerated mouth-to-cecum transit as compared to those without diarrhea (P less than 0.05). Neither the presence of autonomic or peripheral neuropathy nor the presence of liver cirrhosis or ascites was significantly related to gastrointestinal transit times. However, the daily ethanol ingestion significantly correlated with gastric emptying (P less than 0.005). It is concluded, therefore, that in chronic alcoholics the small intestine and the stomach are most likely to be affected by gastrointestinal transit disorders and that these transit abnormalities are potentially related to toxic damage of gastrointestinal smooth muscle.

Adult↗