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Biomedical subjects

D Belohlavek

Publications and source records attributed to D Belohlavek.

At least 19 recordsLinked to original sources
PubMed1979

[Clinical and endoscopic radiologic results after transduodenal papilloplasty (author's transl)].

The study comprises 56 patients, who underwent transduodenal papilloplasty. More than 15% were symptom-free at least 4 years following surgery. All the symptoms the patients suffered from were nonspecific and the pathological findings of the blood samples were not correlated with the width of the orificium of the papilla of Vater or the diameter of the common bile duct. In 49 patients the ERCP was performed. In 48 cases the retrograde cholangiography was successful, in 1 case only the retrograde pancreatography was possible. In all patients we found normal efflux of contrastmedium out of the papilla. Bile stones, one localized in the common bile duct and the other in the cyst remnant were the most important findings. The diameters of the common bile ducts varied considerably and were not dependent on the velocity of the efflux of the contrast medium. Contrary to the observations of other authors, in only 15% of our patients free air bubbles were found in the bile tree. Peripapillary diverticula of the duodenum were detected in 15% of our patients, but did not lead to compression or obstruction of the common bile duct. Even without histologic examination of the liver, we believe that a broad papilloplasty of the papilla prevents an ascending cholangitis or other related complications.

Adult↗
PubMed1978

[Surgical papillotomy, endoscopic-manometric and clinical results (author's transl)].

4--9 years after transduodenal papillotomy an endoscopic-manometric and clinical control of the surgical result was done in 49 patients. The pressure difference of common bile duct and duodenum was of great interest. There existed a correlation between the pressure difference and other parameters so far, as air was frequently seen in those patients without pressure gradient between common bile duct and duodenum. Pathological activity of gamma-GT and a decrease of Prothrombine-time was found after a high pressure difference. It may be possible that anatomical variations of the biliary system and the duodenum have some importance for the formation of stones.

Ampulla of Vater↗
PubMed1978

[The meso-caval shunt--a future standard operation?].

As a result of several retrospective and prospective studies, there have been remarkable changes in surgery for portal hypertension, namely the limitation of surgical interventions to an asymptomatic time interval (without bleeding), and the preference for distal shunt operations, aiming at a lasting reduction of the portal hypertension with minimal reduction of portal liver perfusion. These requirements are best met by the mesocaval (H-) shunt, using a vascular prosthesis with sufficient wall stability and a negatively charged inner surface, such as, for example, the expanded PTFE graft (Gore-TEX). In contrast to several types of splenorenal shunt, the H-shunt in mesocaval position is characterized by the following advantages: (a) minimal operative stress, even in high-risk patients, (b) technical ease of use, (c) reduced operative mortality, especially for interval operations, (d) minimal risk of recurrent bleeding and encephalopathy. From this preliminary report it may be expected that the technique of mesocaval expanded PTFE shunt here presented is likely to become the method of choice in both elective and emergency interventions.

Humans↗
PubMed1977

[Septic temperatures in questionable ascites].

The case history of a 40 year old male with septical temperatures and ascites is presented. Because of skin-pigmentation, hypotension, low rate of electrolytes, augmented renin-activity, and septical temperatures there was a suspicion of Addison's disease. A protein-rich ascites without tumor cells and erythrocytes, but with lymphocytes gives the diagnosis of peritonitis tuberculosa. Addison's disease and peritonitis tuberculosa are late manifestations of an organ tuberculosis, about 20 years after pulmonal tuberculosis.

Adrenal Insufficiency↗
PubMed1977

Plasma secretin and pancreatic bicarbonate response to exogenous secretin in man.

The dose response of duodenal bicarbonate production during synthetic porcine secretin infusions was studied in six healthy volunteers and related to plasma secretin immunoreactivity. Secretin was infused in each individual at four different doses from 0-1 to 2-7 CU/kg/h, each infusion lasting for 60 minutes. Mean maximal bicarbonate secretion was 33 +/- 4 mEq/h. The secretin plasma level for half maximal bicarbonate response was estimated to be 22 pmol/l. As this level is reported to be achieved by intraduodenal acidification in man, it is concluded that secretin may well play a part in the control of duodenal pH.

Adult↗
PubMed1977

Effect of secretin on plasma motilin in man.

Graded doses of 0-1, 0-3, 0-9, and 2-7 clinical units/kg/h of pure synthetic secretin were infused over 60 minute periods in six healthy volunteers. Duodenal bicarbonate output and pH were recorded and plasma secretin and motilin levels were measured by radioimmunoassay. During the infusions plasma motilin fell in a dose dependent manner to a nadir of 35%. This fall was linearly correlated with pancreatic bicarbonate output, whereas a non-linear correlation was observed between plasma motilin and both plasma secretin level and duodenal pH. It is suggested that plasma motilin levels are decreased by secretin-induced pancreatic bicarbonate juice flow. This may be important for the control of motilin secretion initiated by duodenal acidification and the concomitant delay in gastric emptying.

Adult↗
PubMed1976

[New therapeutic methods in gastroenterology].

Operative-therapeutic endoscopy offers new aspects concerning polypectomy, electro- and laser-coagulation of hemorrhages, papillotomy and sclerosing of oesophageal varices. Active and passive immunization in hepatitis A and B will soon become available for clinical trial. The successful synthesis of human gastrointestinal polypeptides may be of clinical significance in the therapy of common gastrointestinal disorders. New surgical procedures adapted to form and function lead rarely to postoperative complaints. Ulcer recurrency seems low when optimal techniques are employed.

Esophageal Diseases↗
PubMed1976

[Effective treatment of duodenal ulcer with cimetidine (author's transl)].

Twelve male duodenal ulcer in-patients received in a double-blind trial either the histamine H2-receptor antagonist cimetidine (4 X 200 mg/d p.o.) or placebo capsules. Ulcer sizes were assessed endoscopically before therapy followed by repeat endoscopy at weekly intervals. Duodenal ulcer healing was significantly more rapid in cimetidine-treated patients than in those receiving the placebo (chi2 test; P less than 0.0005). Plotting of log ulcer sizes (mm2) against time (days) resulted in regression lines the slopes of which indicated the respective half-time of ulcer healing: about 6 days on cimetidine therapy and about 20 days on placebo treatment. Gastric secretion of acid, protein, pepsin, and N-acetylneuraminic acid-containing glycoproteins was not altered by a 4-week course of daily cimetidine or placebo, nor pancreatic secretion of bicarbonate and enzymes. No statistically significant changes in laboratory findings (haemoglobin, white blood-cells, neutrophils, platelets, alkaline phosphatase, blood-urea, serum-creatinine, GOT, GPT) were associated with treatment.

Adolescent↗
PubMed1976

[New aspects and methods in gastroenterological diagnosis].

Advances in the diagnosis of gastrointestinal diseases are achieved by development of new methods and by an improved analysis of the obtained data. New aspects of screening examinations for gastrointestinal cancer in high risk groups concern endoscopic-bioptic methods, the endoscopic retrograde cholangio-pancreaticography, the ultrasonically-guided percutaneous fine-needle biopsy and immunological procedures. An increasing number of gastrointestinal peptides can be determined by radioimmunoassay. Breath tests may improve diagnosis in malassimilation.

Biopsy↗