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Biomedical subjects

B Wedmann

Publications and source records attributed to B Wedmann.

29 records · Page 2Linked to original sources
PubMed1991

[Fasting volume and contractility of the gallbladder after total and subtotal gastrectomy with Y-Roux anastomosis. A prospective study].

Gallbladder volume and contraction after a fatty meal was determined in 14 patients with gastric cancer before and 3-4 months after gastrectomy (7 total and 7 subtotal gastrectomies) with Roux-en-Y anastomosis. All patients had an increased gallbladder resting volume (p less than 0.001) and 10 of 14 patients (6 after total gastrectomy and 4 after subtotal gastrectomy) had an increased minimal residual volume after fatty meal stimulation (p less than 0.01) in the postoperative state, when compared to the preoperative values. It can be concluded that gastrectomy is followed by an impairment of gallbladder tone and contraction, both possibly increasing the risk of gallstone formation.

Adult↗
PubMed1991

Effects of age and gender on fat-induced gallbladder contraction and gastric emptying of a caloric liquid meal: a sonographic study.

In this study, the gastric emptying of a liquid fatty meal and the consecutive gallbladder contraction were simultaneously measured by ultrasound in four different age- and sex-related groups of normal subjects: group A, 15 women less than 50 yr (premenopausal); group B, 15 women greater than 50 yr (postmenopausal); group C, 15 men less than 50 yr; and group D, 15 men greater than 50 yr. Apart from a significantly delayed gastric emptying in the premenopausal women, no significant differences in the postprandial relative gallbladder emptying rates were observed between the four study groups. Ninety-five percent of all study subjects had a gallbladder volume reduction of more than 50% after a liquid fatty meal. It is therefore concluded, that 1) endogenous or contraceptive female sex hormones may have a delaying effect on gastric emptying of caloric liquids in the premenopausal state, 2) aging or gender do not significantly influence the fat-induced gallbladder contraction in man, and 3) a 50% residual volume of the gallbladder after a fatty meal should be considered as the upper limit of normal gallbladder contractility (95 percentile of a normal collective).

Adult↗
PubMed1990

[Sonographic assessment of gastric emptying. Reliability and validity of the antrum sagittal surface method for fluids].

The reliability and validity of sonographic measurements of gastric emptying employing sagittal antral planimetry were investigated. The intraindividual reproducibility of this procedure was examined in 15 healthy volunteers, who ingested 400 ml of water on two separate study days. Simultaneous studies of gastric emptying by ultrasound and scintigraphy were performed on 17 of 20 patients with suspected gastroparesis (16 diabetics and one patient with disseminated encephalomyelitis), using a caloric liquid test meal (20 g Biloptin-fatty meal in 300 ml water at 37 degrees C, radiolabeled with 0.5 mCi 99mTc-colloid). The expansion of the antral area with increasing amounts of ingested fluid and the emptying times showed a good intraindividual reproducibility from day to day (r = 0.94 vs. r = 0.81). There was a significant correlation between the relative residual volumes calculated by scintigraphy and by ultrasound (r = 0.82). These results imply that the ultrasonic sagittal antral area method is reliable and valid in the assessment of gastric emptying rates in humans.

Adult↗
PubMed1989

[Dermatomyositis as a paraneoplastic syndrome. A case report].

A female patient with dermatomyositis with the typical clinical findings of this disease, corresponding histological muscular changes and neurological findings is described. Since in the further course of the disease, recurrent gastric carcinoma was diagnosed, this case again emphasizes the significance of dermatomyositis as a paraneoplastic syndrome, and the need for tumor screening when dermatomyositis is diagnosed in advanced adulthood.

Aged↗
PubMed1989

[The prognostic relevance of tumor localization in colorectal cancer. A multivariate analysis].

Records of 292 patients with colorectal cancer, operated at St.-Josef-Hospital between 1973 and 1984 were studied using Cox regression model to elucidate the prognostic influence of tumor site. Neither in univariate nor in multivariate analysis any significant independent influence of tumor site on prognosis could be detected. Male sex, older age and more advanced tumor stage were independently associated with poorer prognosis.

Aged↗
PubMed1988

Clinical evaluation, ultrasound, cholescintigraphy, and endoscopic retrograde cholangiography in cholestasis. A prospective comparative clinical study.

The accuracy of clinical evaluation (CE), ultrasonography (US), and cholescintigraphy (CS) was prospectively compared in a group of 72 cholestatic patients, using the results of endoscopic retrograde cholangiography (ERC) as the true standard. Forty-six cases (63.9%) had a final diagnosis of extrahepatic biliary obstruction. Clinical evaluation had a sensitivity of 82.6% and a specificity of 46.2% for the identification of mechanical obstruction. Ultrasonography was the single most powerful noninvasive diagnostic procedure, with a sensitivity of 65.2%, a specificity of 92.3%, a positive likelihood ratio of 8.5, and a positive predictive value (PVpos) of 93.8%, which was superior to the diagnostic power of CS (0.05 less than p less than 0.1). Inconclusive results or technical failures were counted as diagnostic errors. Contingency table analyses in an extended group of 112 patients, complete for CE, US, and CS, revealed that concordant results of CE and US had a high probability of correctness (combined PVpos 92.6%, PVneg 98.0%). Contradictory ratings of these two tests were unlikely to be clarified reliably by additional CS. We conclude that the combined evaluation of CE and US allows an accurate differentiation between intrahepatic cholestasis and extrahepatic biliary obstruction. When both give contradictory results, direct cholangiography, rather than further noninvasive procedures, appears to be the diagnostic strategy of choice.

Aged↗
PubMed1987

Gallbladder wall thickening: a frequent finding in various nonbiliary disorders--a prospective ultrasonographic study.

A comprehensive prospective ultrasonographic study was performed in 93 patients to investigate gallbladder wall thickness and gallbladder volumes in various nonbiliary disease states. Without changes in gallbladder volume, mean gallbladder wall thickness was significantly increased (p less than 0.01) in patients with liver cirrhosis, viral hepatitis, chronic congestive heart failure, hypoalbuminemia, and chronic renal failure (p less than 0.05) but not in patients with diabetes mellitus (n = 14) as compared to a control group. The present study confirms that a variety of nonbiliary disorders are associated with significant thickening of gallbladder walls and that this finding is not caused by incomplete gallbladder contraction.

Diabetes Mellitus↗
PubMed1985

[The significance of preoperative and postoperative sonography for biliary tract surgery. A prospective study].

112 patients with biliary calculi and destined for cholecystectomy were sonographically investigated in a prospective study carried immediately before the operation as well as between the third and fifth, and between the seventh and ninth postoperative day. Biliary calculi were sonographically detectable in 111 of the 112 patients (sensitivity 0.99). The sonographically measured bile duct diameter agreed well with the actual bile duct diameter (r = 0.898). There was a correlation between the bile duct diameter and the severity of the underlying biliary disease. A sonographic diagnosis was successful in 11 of 17 patients with choledocholithiasis (sensitivity 0.65) whereas 10 false positive diagnoses gave a specificity of 0.88. Gallbladder wall thickness above 4 mm had a sensitivity of 0.9 and a specificity of 0.72 for the detection of severe chronic or acute cholecystitis. A high rate (50%) of postoperative subhepatic fluid collections was a conspicuous finding but these were predominantly transient or only short-lived and attained clinical significance in only 7 out of 108 patients (6.5%).

Adult↗
PubMedDate not supplied

Effect of cholecystectomy on common bile duct diameters: a longitudinal prospective ultrasonographic study.

The medium-term effect of cholecystectomy on common bile duct diameters (CBD) was investigated prospectively in 64 patients with gallstone disease examined by ultrasonography immediately before and 27 months to 39 months after the operation. In 32 patients with chronic cholecystitis and patent cystic ducts, CBD diameters increased slightly (median 4.6 mm pre- and 5.3 mm postoperatively; p less than 0.05). A group of 19 patients with acute cholecystitis or cystic duct occlusion showed a significant decrease (median 7.7 mm pre- and 5.5 mm postoperatively; p less than 0.05). In 13 patients with common bile duct stones, the CBD diameters also decreased significantly after surgical intervention (median 7.5 mm pre- and 5.0 mm postoperatively; p less than 0.05). The widest CBD diameter after cholecystectomy observed in this study was 10 mm. We conclude that either increases or decreases of the CBD diameters may occur after cholecystectomy in patients with calculous gallbladder disease, and that the postoperative evolution is governed by the exact nature of the underlying biliary disease at the time of the index operation.

Acute Disease↗
PubMedDate not supplied

Sonographic evaluation of gallbladder kinetics: in vitro and in vivo comparison of different methods to assess gallbladder emptying.

In an in vitro study, 10 gallbladders of adult pigs and 6 gallbladders of lambs, all removed immediately after slaughtering, were stimulated in a water bath by electric means to induce active contraction. Gallbladder emptying was followed by ultrasonography employing five measurement procedures: (1) gallbladder width, (2) longitudinal planimetry, (3) transverse planimetry, (4) ellipsoid method, and (5) sum of cylinders method. In an in vivo investigation, gallbladder emptying of 30 volunteers (12 healthy subjects, 18 diabetics) was evaluated in the same way after ingestion of a fatty meal. Gallbladder width was found to be unsuitable to estimate the decrease in gallbladder volume due to a nonlinear relation of the parameters. Longitudinal planimetry tended to be less valid than transverse planimetry in assessing gallbladder volume reduction. The most valid estimation of gallbladder volume decreases was obtained by the two three-dimensional procedures. However, in neither in vitro nor in vivo could a significant difference between the sum of cylinders method and the ellipsoid method in determining relative volume reduction be established. We conclude that a three-dimensional measurement procedure should be used for valid assessments of gallbladder motility. However, according to our data there is no advantage in using the time-consuming sum of cylinders method compared to the simple ellipsoid method.

Adult↗