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Biomedical subjects

D Schlauch

Publications and source records attributed to D Schlauch.

13 recordsLinked to original sources
PubMed1999

Short-term triple therapy with lansoprazole 30 mg or 60 mg, amoxycillin and clarithromycin to eradicate Helicobacter pylori.

BACKGROUND: We investigated the efficacy of 30 vs. 60 mg lansoprazole daily in a 1-week triple therapy for eradication of Helicobacter pylori in a prospective randomized study. METHODS: Two hundred and fifteen consecutive out-patients with peptic ulcer disease or non-ulcer dyspepsia, in whom H. pylori infection was confirmed by histology and/or a urease biopsy test, were randomly assigned to a 1-week treatment with either 15 mg lansoprazole b.d. (LAC15 group) or 30 mg lansoprazole b.d. (LAC30 group) in combination with 1 g amoxycillin b.d. and 500 mg clarithromycin b.d. RESULTS: Eradication of H. pylori was successful in 87% (per protocol) and 82% (intention-to-treat) of the patients with LAC15 and in 94% (per protocol) and 87% (intention-to-treat) of the patients with LAC30. The difference was not significant. In both treatment groups, all peptic ulcers were healed at the check-up. Adverse effects were seen in 11 patients of the LAC15 group and 10 patients of the LAC30 group: they caused discontinuation of the therapy in four of the LAC15 group and two patients of the LAC 30 group. CONCLUSIONS: A 7-day triple therapy using lansoprazole (LAC15) is an efficient and economical regimen for the eradication of H. pylori.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1993

Direct dissolution of gallstones with methyl tert-butyl ether by endoscopic cannulation of the gallbladder.

Methyl tert-butyl ether (MTBE) rapidly and effectively dissolves cholesterol gallbladder stones. Due to the invasive nature of transhepatic catheterization, we studied the safety and efficacy of MTBE stone dissolution, delivered by endoscopic, retrograde cannulation of the gallbladder. Extracorporeal shock-wave lithotripsy (ESWL) was employed in patients with multiple stones, to increase contact surface area and facilitate dissolution. We successfully cannulated the gallbladder in 13/17 patients (76.5%) attempted, with no associated complications. After cannulation, MTBE lysis was then conducted on all patients, and 10/13 patients (77%) cannulated were either stone-free at completion, or had only residual gallbladder sludge. Predissolution ESWL successfully fragmented stones in 6/7 patients (86%) in which it was attempted. Both ESWL and MTBE were well tolerated by all patients. Endoscopic retrograde cannulation of the gallbladder and MTBE dissolution is a promising alternative for the treatment of gallbladder stones in patients who will not receive surgery.

Aged↗
PubMed1992

Intraductal shock-wave lithotripsy in complicated common bile duct stones.

Intracorporeal shockwave lithotripsy was performed in 36 patients with problematic common bile duct stones. All of the patients had undergone unsuccessful mechanical lithotripsy prior to this procedure. In 29 patients (80.6%), the stones were fragmented under cholangioscopic control and subsequently extracted with a Dormia basket. In seven patients, the procedure failed due to stone impaction or failure to intubate the common bile duct with a nasobiliary tube. No complications were observed. Cholangioscopically guided intracorporeal shockwave lithotripsy is a highly effective and safe procedure for the conservative treatment of complicated common bile duct stones.

Aged↗
PubMed1992

[Endometriosis of the terminal ileum--differential diagnosis of Crohn disease].

Ileocecal resection was performed in two female patients with stenosis of the terminal ileum. Histological findings confirmed the clinical diagnosis of Crohn's disease in the first case, although focal intestinal endometriosis was detected. The resection specimens of the other patient exclusively showed lesions of endometriosis extending from the subserosa to the mucosal tissue. Typical lesions of Crohn's disease were totally absent in this case. Although not very frequent, endometriosis is an important differential diagnosis of Crohn's disease in young females.

Adult↗
PubMed1991

[Esophageal motility disorders with thoracic pain of unknown origin].

35 patients with angina-like chest pain underwent esophageal manometry after a coronary artery disease had been ruled out by angiography. Furthermore, patients after gastric or esophageal surgery, with pathologic upper gastrointestinal endoscopy or with pathologic gastroesophageal reflux as seen on 24-hour-pH-metry were excluded from this study. 29 out of 35 patients (83%) had a normal manometric study, six patients (17%) had a motility disorder; five of these showed an unspecific dismotility pattern and were asymptomatic while the study was done; only one patient presented with esophageal spasm. Since only this latter patient was symptomatic while the study was done, a correlation between symptoms and this motility disorder seems likely. --If pathologic gastroesophageal reflux has been ruled out, esophageal manometry can establish a diagnosis in only 3% of patients with angina-like chest pain without esophageal symptoms (dysphagia, odynophagia, heartburn or regurgitation). We conclude that this complicated examination should not be done in these patients.

Adult↗
PubMed1990

Coagulopathy after snake bite by Bothrops neuwiedi: case report and results of in vitro experiments.

Coagulation studies were performed in a patient who had been bitten by a snake of the species Bothrops neuwiedi. The patient presented with hemorrhagic necrosis at the envenomization site and considerable bleeding from venous puncture sites. He developed a severe defibrination syndrome with a clottable fibrinogen level of approximately 0.1 g/l. Fibrinogen was not measurable by clotting time assay. Fibrin degradation products were greatly elevated. Treatment with antivenom caused an anaphylactic reaction within ten minutes and serum sickness after three days. In vitro experiments revealed that B. neuwiedi venom directly activates Factors II and X, but does not activate Factor XIII. In vivo consumption of Factor XIII after B. neuwiedi envenomization is ascribed to the action of Factor IIa. At low venom concentrations clotting is initiated by activation of prothrombin by the venom either directly or via Factor X activation. Treatment with heparin might be beneficial in coagulopathy secondary to snake bite by reducing circulating active thrombin. The venom contains thrombin-like proteases which cause slow clotting of fibrinogen, and plasmin-like components causing further proteolysis of fibrinogen and fibrin. Antivenom has no effect on the proteolytic action of the snake venom. The in vivo effects of antivenom are presumably caused by acceleration of the elimination of venom components from the circulation. Intravenous administration of antivenom caused normalization of blood coagulation parameters within 48 h.

Adult↗
PubMed1988

A model for the comparison of pharmacologic agents influencing gallbladder contraction.

Investigations on pharmacologic effects on gallbladder contraction must take into consideration the spontaneous motility of the gallbladder. In 20 healthy subjects, we measured the area of the gallbladder sonographically over 10 h at hourly intervals. The spontaneous motility expressed as a coefficient of variation varied between 1.6 and 13% (mean value, 6.3%). Afterwards, we checked the cholecystokinetic action of ceruletide and fatty meal in eight subjects. Here, an alteration of the area by four times the previously found coefficient of variation was defined as significant. A significant contraction occurred earlier after ceruletide administration than after a fatty meal (10 min as compared to 20 min). This lasted longer (40 min. vs. 25 min) and led to a very much more marked reduction in area (69% as compared to 53%). These differences were significant on a 5% level. The end of the contraction did not differ (50 min as compared to 45 min). We conclude that drugs which affect gallbladder contraction can be compared with consideration of spontaneous motility.

Adult↗
PubMed1988

A simple technique for sonographic estimation of liver volume.

A procedure for estimation of liver volume with the sonographic real-time technique is reported. Testing of this procedure in vitro revealed a very good linear correlation of sonographically determined liver volumes and liver volumes measured by water displacement. In an in-vivo measurement of 70 healthy subjects, a mean of 1402 ccm was determined for men and 1257 ccm for women. A statistically significant correlation was found with body weight and body surface. The method presented is simple and can be carried out in a short time during a routine examination.

Adult↗
PubMed1986

[Differential diagnosis of jaundice by combined noninvasive diagnostic means using a logistic discriminant analysis].

Using a logistic discriminant function we retrospectively evaluated the diagnostic value of laboratory features and abdominal sonography in 70 patients with jaundice. 18 patients had an extrahepatic obstruction of the common bile duct (EHO), 22 patients had metastatic liver disease (MLD) and 30 patients had an infectious or toxic hepatocellular disease (HCD). The sensitivity resp. specificity of the 5 laboratory values AP, GGT, GPT, GOT and bilirubin was 22% resp. 90% for diagnosing EHO, 82% resp. 79% for diagnosing MLD and 67% resp. 68% for diagnosing HCD. The diagnostic value determined by their Chi2-value was AP greater than GPT greater than bilirubin greater than GOT greater than GGT. An undoubtedly dilated common bile duct was seen in 56% of the patients with EHO and in none of the other patients. Metastatic lesions were seen exclusively in 81% of the patients with MLD. No distinct sonographic sign could be found for the patients with HCD. The combination of AP, GPT and bilirubin with the result of abdominal sonography in a logistic discriminant function led to a correct a posteriori classification of all patients. Using a mathematical classification model jaundiced patients can be diagnosed on the basis of noninvasive methods alone and invasive procedures should be restricted to therapeutic interventions.

Cholestasis, Extrahepatic↗
PubMedDate not supplied

[Enteroscopy--expansion of the diagnostic spectrum. Review and personal results].

The source of blood loss remains undetermined in 5% of patients with chronic gastrointestinal bleeding. Small bowel enteroscopy using a prototype of a sonde-type enteroscope was performed in 27 patients with chronic or subacute gastrointestinal bleeding of obscure origin. The procedure time ranged between 1.5 and 6.5 hours (mean = 4 hours 15 minutes). Sonde-type enteroscopy showed vascular malformation as possible source of bleeding in 22% of our patients. We conclude that sonde-type enteroscopy is a reasonable diagnostic procedure before performing intraoperative enteroscopy. Indications for laparotomy are persisting at negative enteroscopy or enteroscopic finding making surgical therapy necessary.

Adult↗