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F Hagenmüller

Publications and source records attributed to F Hagenmüller.

At least 19 recordsLinked to original sources
PubMed1998

The minimal standard terminology for digestive endoscopy: introduction to structured reporting.

The wider use of computers for the management of endoscopic data and the use of electronic endoscopes for the production of high quality endoscopic images has made the standardization of terminology and images formats necessary in digestive endoscopy reports. The European Society for Gastrointestinal Endoscopy and the American Society for Gastrointestinal Endoscopy have combined their efforts to propose a Minimal Standard Terminology for Computerized Databases in Endoscopy. This terminology is based on the following principles: no term describing findings less frequent than 1%, of the daily practice, and no term based on subjective impressions. The Minimal Standard Terminology has been developed according to the natural process of constructing an endoscopic report in natural language and deals with the following: reasons for performing the examination, endoscopic findings, endoscopic diagnosis, additional therapeutic and diagnosis procedures (biopsies, etc.). It is subdivided according to the main organs examined with an endoscopy. Until now, the Minimal Standard Terminology was tested in many centers and was shown to accurately cover 95% of routine examinations for the upper gastrointestinal tract, colonoscopy and cholangio-pancreatography. It is currently being tested in an a prospective way in several centers in Europe (with a grant from the European Commission DGXIII-C4) and in the USA (with grant from the AHDHF).

Endoscopy, Digestive System↗
PubMed1997

Expression of CD66a (human C-CAM) and other members of the carcinoembryonic antigen gene family of adhesion molecules in human colorectal adenomas.

Among the members of the carcinoembryonic antigen (CEA) family, CD66a (human C-CAM) and CGM2 (CEA gene family member 2) mRNAs are frequently down-regulated in colorectal cancer. In contrast, nonspecific cross-reactive antigen (NCA) mRNA is overexpressed in the majority of these carcinomas. In animal models, the rodent homologues of CD66a have been shown to act as tumor suppressors, suggesting an important role in carcinogenesis. Here we investigate the mRNAs of CD66a, CGM2, and NCA in 22 human colorectal adenomas and the respective normal mucosa specimens by Northern blots. The expression of both CD66a and CGM2 changed in a concomitant fashion. Using oligonucleotides specific for the N-terminal domains, two CD66a transcripts 3.9 and 1.5 kb in size were identified. These showed a greater than 50% down-regulation in 20 of 22 and 18 of 22 adenomas, respectively. Reduction of the CGM2 message was observed in 21 of 22 cases. Complete or near-complete losses of the CD66a 3.9-kb mRNA and the CGM2 message were found in 13 of 22 and 15 of 22 of the tumors, respectively. The medians of CD66a and CGM2 expressions were between 0.3 and 0.0, respectively. The tumor:normal ratio of NCA mRNA expression was increased up to 2.4-fold in 11 of 22 adenomas. Altogether, these results compare well to the changes reported previously for colorectal carcinomas. The high frequency and early appearance of dysregulation of members of the carcinoembryonic antigen family during colorectal tumorigenesis suggests that these changes may be important for the development of the malignant phenotype.

Adenoma↗
PubMed1997

[Nasobiliary tube in management of postoperative bile fistulas].

A postoperative bile fistula is a rare but severe complication after biliary surgery. Clinical signs, laboratory findings, ultrasound and ERC lead to diagnosis. We report on 40 cases with postoperative bile leakage after cholecystectomy treated by a nasobiliary tube. In all patients the fistula healed within 7 days after placement of the tube. Two patients needed operative treatment of a subhepatic abscess, and in 2 patients drainage of a bilioma was performed. In 2 cases with biliary peritonitis, a step-by-step lavage was necessary. The nasobiliary tube for postoperative bile fistula offers regular radiological control and reduces the necessity of operative reintervention in the biliary tract.

Adult↗
PubMed1995

[Multicenter prospective study of the current status of treatment for bleeding ulcer in Germany].

The current state of ulcer treatment in Germany was analysed in a prospective multi-centre study. It was based on 1139 consecutive patients admitted to the participating hospitals because of upper gastrointestinal bleeding. The source of the bleeding was identified by diagnostic endoscopy in 1075 patients (94%), from a gastric and/or duodenal ulcer in 546 of them (mean age 62 +/- 18 years). Using Forrest's classification, 4% of patients were in bleeding stage Ia, 17% in stage Ib, 16% stage IIa, 30% stage IIb and 33% stage III. An attempt to arrest bleeding through the endoscope was made in 233 patients (43%): more often with tissue-preserving substances (epinephrine +/- NaCl in 36%, fibrin glue +/- epinephrine in 24%) than with tissue-damaging procedures (epinephrine + polidocanol +/- NaCl in 26%, epinephrine + thermocoagulation in 7%). Primary haemostasis was achieved in 219 patients (94%). There was a total of 66 recurrences of bleeding (12%), but the rate was 18% after endoscopic haemostasis. 64 patients (12%) required operative intervention, including initial emergency operations. Severe complications (infections, organic failure) occurred in 82 patients (16%). 114 of the 546 patients were in the high risk group (older than 60 years; high amount of bleeding). Their bleeding recurrence and mortality rates (27 and 22%, respectively) were significantly higher (P < 0.01) than those of the total group. Overall mortality rate was 11% (58 patients). The mortality rate depended on the severity of initial bleeding (26% for Forrest group Ia). After recurrent bleeding the mortality rate was 34% with conservative and 33% with operative treatment. 7% of all deaths were the direct result of bleeding. The following factors prognostically closely correlated with mortality rate: age of patient (P < 0.01); haemoglobin < 8 g/dl on admission (P < 0.05); initial severity of bleeding (Forrest group I; P < 0.05); and recurrence of bleeding (P < 0.001).

Age Factors↗
PubMed1994

[Endoscopic therapy of postoperative biliary fistula].

A postoperative biliary fistula is a rare but severe complication of biliary surgery. Clinical signs, ultrasound and ERC lead to the diagnosis. Within three years, 37 patients with postoperative bile duct fistulas after cholecystectomy underwent endoscopic therapy. In all patients the biliary fistula healed completely within seven days after insertion of a nasobiliary tube. The nasobiliary tube for postoperative biliary fistulas offers regular radiological controls and reduces the necessity of operative reinterventions on the biliary system.

Biliary Fistula↗
PubMed1992

Biliary stent occlusion--a problem solved with self-expanding metal stents? European Wallstent Study Group.

The main limitation in the endoscopic palliation of malignant biliary obstruction is due to stent blockage. One of the factors thought to be of importance is the diameter of the endoprosthesis. In this paper, we report the results of a multicenter European study with a one cm diameter self-expanding metal stent (Wallstent) in 103 patients with malignant biliary obstruction. Insertion of the stent following guidewire positioning was successful in 97.1% of the patients without any cases of de novo cholangitis developing after the endoscopic procedure. The median follow-up for the entire group was 145 days. In all but 3 patients, the stent expanded to more than 80% of its maximum diameter. Two patients had ongoing cholangitis after stent insertion. Long-term complications manifested by late cholangitis, were seen in 18% of the cases after a median interval of 125 days. The occlusion rate by biliary sludge was 5% after a median time period of 175 days which is substantially less than the 21% occlusion rate reported for polyethylene stents. In conclusion, our results show that the Wallstent can be easily placed in distal and mid-CBD strictures after guidewire passage, with most of the patients having a- good drainage effect. The occlusion rate by biliary sludge is significantly less than for conventional polyethylene stents, but the occlusion by tumor ingrowth is substantial. A disadvantage is the high cost of the Wallstent. Further randomized trials will be required to determine the cost-benefit ratio for the use of this stent.

Adult↗
PubMed1991

Fish oil reduces ethanol-induced damage of the duodenal mucosa in humans.

Eight healthy volunteers were studied before and after 3 weeks of dietary supplementation with fish oil (10.5 g day-1, 18% (1.9 g) eicosapentaenoic acid). Duodenal mucosal lesions were induced by instillation of 40 ml ethanol (40%). Mean endoscopic lesion score was lower after fish oil treatment (1.62 +/- 0.32; mean +/- SEM) than before (3.25 +/- 0.31; P less than 0.01). Histologic lesion score fell from 22.75 +/- 1.98 before treatment to 13.50 +/- 1.51 after fish oil (P less than 0.01). Basal and pentagastrin-stimulated gastric acid output remained unaffected. Release of prostaglandin E2, 6-keto-prostaglandin F1 alpha, and thromboxane B2 from biopsy specimens of the duodenal mucosa in vitro was not significantly altered after fish oil ingestion. In the same in vitro system calcium ionophore A23187-induced release of total leukotriene C (LTC) increased from 10.6 +/- 1.5 ng g-1 mucosa 20 min before treatment to 30.4 +/- 3.2 ng after fish oil. High pressure liquid chromatography analysis showed that this increase was partly due to formation of LTC5 as after fish oil 28% of total LTC were identified as LTC5 whereas 72% were LTC4. We conclude that in humans fish oil reduces ethanol-induced damage of the duodenal mucosa without inhibiting gastric acid secretion or stimulating prostaglandin formation. It remains to be clarified if the changes in leukotriene formation are relevant for the mucosaprotective fish oil effect.

6-Ketoprostaglandin F1 alpha↗
PubMed1991

[Self-expanding and expandable bile duct prostheses].

The main problem of conventional endoscopic or percutaneous biliary drainage is the clogging of plastic endoprostheses. Therapeutic advances may be achieved by self-expanding or balloon-expandable braided or slit metal stents due to their large lumen and small surface area. Preliminary clinical studies show excellent early results but a divergent long-term clinical outcome depending on the selection of patients, the implantation technique or the type of the stent. If a long-distance overlap of biliary stenoses is achieved the metal stents may be superior to plastic prostheses due to a reduction of the risk of bile encrustation.

Bile Duct Neoplasms↗
PubMed1990

[Endoscopic and percutaneous implantation of self-expanding endoprostheses in biliary stenosis].

Self-expanding metal stents were implanted in 30 patients (14 men and 16 women, mean age 67 [40-86] years) with malignant (n = 27) or benign (n = 3) obstruction of the biliary tract (hepatic duct bifurcation: n = 14; choledochal duct: n = 16). The stents were introduced and left in place endoscopically in 13, percutaneously and transhepatically via a 7 or 9 F catheter in 17 patients. The stents, which expand to a diameter of 7-10 mm, in all cases achieved complete drainage, as confirmed by cholangiography. Jaundice completely disappeared in 28 of 30 patients. No complications were noted during a 30-day period of observation. After a median follow-up period of 90 days, 17 patients have been without jaundice for a median period of 141 (30-330) days. A recurrence of jaundice was noted in three patients (restenosis proximal to the stent in 2, incrustation with bile in one). Ten patients died, without any signs pointing to stent occlusion. These data indicate that the probability of stent patency in malignant stenoses of 200 days after implantation is 84%, so that stents in most cases provide a safe and effective means of drainage. Because they have a relatively large lumen with small surface area infection, occlusion and migration apparently occur less often than with conventional synthetic prostheses.

Adult↗
PubMed1990

Toxic shock-like syndrome due to severe hemolytic group A streptococcal infection.

A 33-year-old woman suffering from anal erosions developed severe illness with fever, diarrhea, ischalgia, hypotension, acute abdominal pain, dyspnea, renal and hepatic impairment, myalgia, desquamation of the skin, leukocytosis, anemia, hypocalcemia, decreased serum albumin, and cholesterol levels. Exploratory laparotomy did not reveal pathologic findings. Hemolytic group A streptococci were grown from peritoneal swabs and pleural exudate in bacteriologic cultures. The patient slowly recovered after intense penicillin and tobramycin therapy.

Adult↗
PubMed1990

[Electromagnetic shockwave lithotripsy of gallstones. Preliminary clinical experiences].

75 applications of extracorporeal electromagnetically produced shock-waves were performed on 40 patients with symptomatic gallbladder stones (27 women and 13 men; mean age 43.5 [25-69] years). The patients had up to three stones each, with a maximal diameter of 35 mm. Computed tomography revealed partial calcification of the stones in nine patients. Stone fragmentation succeeded in all patients. Two weeks after lithotripsy two patients were free of stone. Maximal fragment diameter, as measured by ultrasound, was less than 6 mm in 19 patients, 6-10 mm in 14, and 11-15 mm in five. At reexamination of 24 patients three months later, three additional patients were free of stone by ultrasound. No significant side effects were noted during the first 30 days after the procedure. But during further observation mild pancreatitis developed in two, while in one choledochal concrements caused obstructive jaundice which necessitated endoscopic papillotomy. These results demonstrate the effectiveness of this method of fragmenting gall-bladder stones.

Adult↗