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Biomedical subjects

G Lux

Publications and source records attributed to G Lux.

At least 19 recordsLinked to original sources
PubMed1992

Granulomatous tonsillitis. A rare extraintestinal manifestation of Crohn's disease.

Oral lesions, varying in nature and location, appear to be one of the common extraintestinal manifestation of Crohn's disease. In particular, oral involvement preceding intestinal disease may lead to the diagnosis of Crohn's disease. The present case report of a 17-year-old male patient describes a very rare nonintestinal manifestation of Crohn's disease with severe granulomatous involvement of the tonsils. A sore throat caused by hyperplastic tonsils with granulomatous inflammation as an oral manifestation of Crohn's disease was the leading symptom in this case.

Adolescent↗
PubMed1991

[Percutaneous sonographically guided fine-needle puncture and drainage of pyogenic abscesses].

Between January 1988 and April 1991, a total of 79 ultrasound-directed percutaneous punctures and (or) drainage of abscesses were performed on 31 patients (15 men, 16 women; mean age 63 [31-85] years). There were 14 hepatic, 4 splenic, 4 abdominal wall and 3 pancreatic abscesses, and one each subphrenic, presacral, retrocaecal, ischiorectal, pulmonary and in the psoas. After ultrasound localization of the abscess a fine-needle puncture was performed, after which the abscess cavity was emptied as much as possible or, in abscesses larger than 5 cm in diameter, drained through a pig-tail catheter (6-8, 4 F). Several punctures were needed in 16 patients, while in 15 a percutaneous drainage over 2-8 days was necessary. Treatment was successful after 4-17 days in 25 patients. One patient died in septic shock. Operative intervention after diagnostic puncture was undertaken in 5 patients. There were no complications related to the method. In 11 patients the further course was determined by an underlying malignant disease. No recurrence has been noted (4-36 months after treatment) in 14 patients with a benign underlying disease. Percutaneous puncture and drainage of pyogenic abscesses is a technically simple method which achieves good results.

Abscess↗
PubMed1991

[Lysis of gallstones with methyl tert-butyl ether: percutaneous transhepatic or transpapillary?].

Thirty patients (23 women, 7 men, mean age 53 [24-77] years) with symptomatic radiolucent gallbladder stones were treated by litholysis with methyl tert-butyl ether (MTBE), introduced through a catheter inserted into the gallbladder either by the percutaneous-transhepatic route (n = 19) or the transpapillary route (n = 11). Correct placing of the catheter was more frequently successful by the percutaneous-transhepatic route than the transpapillary one (90 vs 73%). The duration of lysis (median: 7 h and 8 h, respectively) and the proportion of stones which were completely dissolved immediately after lysis (53 vs 55%) were similar in both groups. Supplemented by subsequent oral therapy, the success rate at 6 months was higher in the percutaneous-transhepatic group (83 vs 64%), however, recurrences were more frequent. In the percutaneous-transhepatic group there was one case of gall-bladder leak and one catheter dislocation, and in the transpapillary group there was one case of pancreatitis, one of induction of ether anaesthesia and one pulmonary embolism. MTBE lysis is a relatively speedy and effective mode of non-operative therapy for gall-bladder stones. The percutaneous-transhepatic method is suitable for younger patients with a normal gall-bladder. The transpapillary procedure is preferable for older patients, and also when gall-bladder puncture proves difficult or when there is concurrent choledocholithiasis.

Adult↗
PubMed1991

Esophageal visible vessel as a cause of massive upper gastrointestinal hemorrhage.

Besides peptic ulcers, erosions, esophageal varices, tumors and non-variceal esophageal lesions, vascular abnormalities lead to an upper gastrointestinal hemorrhage in 1-5% of cases. Among 581 emergency esophagogastro-duodenoscopies for acute gastrointestinal bleeding performed in our institution between 1987 and 1989, an esophageal visible vessel was found to be the source of massive hemorrhage in five patients. All patients were males with ages ranging from 37 to 84 years. Esophageal visible vessel was localized in one patient in the middle third and in four patients in the distal portion of the esophagus. Using the Forrest classification, endoscopy revealed an oozing hemorrhage (Ib) in two patients and a protruding vessel (IIa) in three patients. Definitive hemostasis could be achieved in all patients by local injection of adrenaline combined with heater probe thermocoagulation. In some patients with recurrent upper gastrointestinal bleeding, visible esophageal vessel is a rare source of bleeding that has not yet been described.

Adult↗
PubMed1990

[Gastroesophageal reflux disease].

Gastro-esophageal reflux disease is primarily a functional disorder. Morphological manifestations occur secondarily. Primary functional changes include spontaneous relaxation and insufficiency of the lower esophageal sphincter, delayed gastric emptying and impaired esophageal peristalsis. The diagnosis is established by endoscopy--in special cases by pH-metry. Therapy comprises general measures and specific drug treatment with H2-blockers, omeprazole and prokinetics. Prophylaxis of recurrence is a problem that remains to be solved.

Esophagitis, Peptic↗
PubMed1990

Endoscopic management of malignant biliary obstruction and recurrent cholangitis with a self-expanding prosthesis.

Endoscopic implantation of a prosthesis usually provides effective palliation in malignant biliary obstruction and in some cases of benign strictures. The most common problem concerning stent patency is occlusion, which may lead on to cholangitis and septic complications. A new technique employing self-expanding stents offers encouraging results. Preliminary clinical experience with expanding biliary stents are reported. The expectations of the doctor and patient, and the preferences and advantages of this new method are discussed on the basis of a case report with recurrent septic complications caused by conventional biliary prosthesis.

Aged↗
PubMed1990

Myoelectric and manometric patterns of human rectosigmoid colon in irritable bowel syndrome and diverticulosis.

Rectosigmoid electric control activity and intraluminal pressure were measured in the fasting state and after a standard 3040-kJ meal in irritable bowel syndrome (IBS) patients (n = 41), diverticulosis patients (n = 15), and healthy controls (n = 13). Analysis of myoelectric and motor patterns was performed computer-based with home-made software. Spectral analysis (fast Fourier transform) and computer recognition of slow waves emulating visual scoring showed very similar slow-wave frequency patterns in all three groups. Calculation of contractile indices displayed a widely scattered variable of motility in all three groups without significant differences. IBS subgroups with different bowel patterns showed very similar frequencies of basic myoelectric rhythm and a considerable overlap of contractile activity without significant differences among the subgroups and compared with controls. Slow-wave rhythm seems unlikely to be the basis of disturbed motility in IBS and diverticular disease. A specific pattern of contractile activity was not detectable in either condition.

Adult↗
PubMed1990

[Myelolipoma of the adrenal gland].

Myelolipomas of the adrenal gland are rare, nonfunctioning and benign tumors. The etiologic feature of these tumors, composed of fat and hematopoietic elements, remains unclear. Usually, myelolipomas of the adrenal gland, which are mostly asymptomatic, are recognized incidentally. Sonographic demonstration of the hyperechoic tumor combined with fine-needle aspiration biopsy reveals a prompt diagnosis. Computed tomography and adrenal angiography are complementary techniques. In most of the cases, a surgical treatment is indicated if the tumor becomes evidently symptomatic.

Adrenal Gland Neoplasms↗
PubMed1990

[Annular pancreas--a congenital abnormality of the pancreas].

Our case report on a 26-year-old male suffering from epigastric pain for several years should emphasize the fact, that even a rare congenital malformation like the annular pancreas must seriously discussed as a reason for the so called unspecific abdominal pain. Embryological development, age of manifestation, symptoms and therapeutic concepts are described. The importance of endoscopic methods such as gastroduodenal endoscopy and endoscopic retrograde cholangiopancreatography (ERCP) for a more precise and frequent diagnosis will be strengthened and the influence on the prevalence will be discussed.

Adult↗
PubMed1989

[Differential diagnosis of dysphagia, globus feeling and hiccup].

The differential diagnosis of dysphagia is one of the more rewarding tasks of internal medicine. In the large majority of cases, careful history-taking suffices to permit the classification of the underlying disorder. Singultus has a wide range of causes: neurological, psychological, toxic, pulmonary and gastro-enterological. Treatment may prove difficult. A wide spectrum of drugs and general measures has been reported to be effective in the case of singultus.

Deglutition Disorders↗
PubMed1989

[Differential diagnosis of gastrointestinal hemorrhage].

Acute gastrointestinal bleeding is one of the classical emergency situations in medicine. Some 100 hospitalizations per 100,000 inhabitants per year are assumed. The mortality rate of gastrointestinal bleeding continues to be about 10 per cent. Those affected are in rate of gastrointestinal bleeding continues to be about 10 per cent. Those affected are in particular patients of more advanced age. The cardinal symptoms hematemesis, melena, hematochezia, stimulate a step-wise approach with parallel diagnosis and therapy. Emergency endoscopy does not result in any significant improvement in prognosis if the patients are considered overall. Only about 20 per cent of the referred patients, that is those with a persistent bleed, profit from the possibility of accurate endoscopic diagnosis. The techniques of endoscopic hemostasis are presently under discussion; in the case of inoperable patients they represent the sole possibility.

Diagnosis, Differential↗
PubMed1989

Gut hormone release by intraduodenal stimulation in duodenal ulcer patients.

After an overnight fast, plasma levels of gut peptide hormones were determined before and after intraduodenal stimulation (IDS) with glucose and citric acid in 8 patients with a recent endoscopically proved duodenal ulcer (DU) attack and in 8 healthy volunteers. The DU patients had a hyperacidic mean BAO of 6.6 and an average PAO of 41.8 mEq/h. In DU, basal secretin levels were similar to those in controls, and after IDS secretin release was not impaired. There was no defect of VIP liberation or of the neurotensin response (basal 21 +/- 7 vs 16 +/- 3, after IDS 68 +/- 28 vs 35 +/- 5 pmol/l) which could account for gastric acid hypersecretion. Although fasting GIP levels were significantly lower than in controls (16 +/- 2.5 vs 25 +/- 1.4 pmol/l), they did not correlate negatively with BAO. In contrast to former studies with oral test meals, integrated GIP release was rather reduced after IDS. Basal plasma levels of gastrin were significantly lower in DU (4.0 +/- 0.4 vs 12 +/- 2 pmol/l) and were inversely related to BAO (r = -0.82, p less than 0.02). From the present data, there is insufficient evidence for abnormal plasma levels of gut hormones as major etiologic factors for basal hyperchlorhydria in ordinary DU disease.

Adult↗
PubMed1989

Coeliac sprue: abnormalities of the hormone profile of gastroduodenal mucosa.

To further characterize coeliac sprue, the hormonal content of routine endoscopic biopsies of gastroduodenal mucosa was estimated in 5 coeliac sprue patients and in 8 volunteers without upper gastrointestinal disease. Levels of cholecystokinin-like immunoreactivity tended to be lower in duodenal mucosa of coeliac sprue patients, while the mucosal map of GIP and somatostatin exhibited no peculiar profile. Gastrin was markedly elevated in the antral mucosa of coeliac sprue patients (3013 +/- 760 versus 1048 +/- 392 pmol/g), while basal plasma gastrin was normal. The mucosal VIP content of the descending duodenum was significantly higher in coeliacs than in controls (409 +/- 161 versus 81 +/- 16 pmol/g) and tended to be increased also in the remaining upper small intestine. This rise may be a reaction to mucosal irritation and a reason for enhanced fluid secretion. Even in antral mucosa of coeliac sprue patients, VIP levels were elevated when compared to controls (82 +/- 14 versus 40 +/- 8 pmol/g) and may have some impact, e.g. on local mucosal blood flow or mucus secretion. The mucosal concentration of another putative neurotransmitter, substance P, also showed a tendency to be raised in the mucosa of upper small intestine of coeliac sprue patients.

Biopsy↗
PubMed1989

Antigen-induced histamine-release from duodenal biopsy in gastrointestinal food allergy.

Twenty-four patients allergic to food, which was demonstrated by oral provocation, were investigated. Six particles from duodenal mucosa were obtained during endoscopic examination and incubated with different foods. Specimens challenged by anti-human-IgE or without any stimulus served as control values. Also, skin tests and assays of specific IgE were performed. The spontaneous histamine release varied from 19% to 36%. Anti-IgE caused an increase up to 26% until 65%. Incubation with allergenic food induced a histamine release from 41% to 81%, demonstrating positive results in 27 out of 30 separate experiments. Antigen-induced histamine release from biopsy specimens turned out superior to skin tests and specific IgE. It is the most reliable tool for diagnosis of gastrointestinal food allergy besides oral provocation.

Adult↗
PubMed1989

[Disorders of gastrointestinal motility--diabetes mellitus].

Diabetic motility disturbances are frequent and may be found within esophagus, stomach, small bowel, colon and anal sphincter. Disturbed motility may explain gastrointestinal symptoms of patients with diabetic enteropathy, but there is no correlation between symptoms and extent of motility changes. Prokinetic drugs relief symptoms, but also without improving motility parameters. Diarrhea is best treated by local opoid agonists (loperamide), in anorectal incontinence biofeedback training is also to be recommended.

Autonomic Nervous System↗