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Biomedical subjects

H Pamperl

Publications and source records attributed to H Pamperl.

15 recordsLinked to original sources
PubMed1994

Malignant bile-duct obstruction: experience with self-expanding metal endoprostheses (Wallstents) in Austria.

Fifty-two patients in nine Austrian hospitals were treated with biliary self-expanding metal endoprostheses (Wallstents) for malignant biliary obstruction, and followed up retrospectively using questionnaires, answered by the endoscopists. Stent placement was successful in all patients. The technical failure rate at the first attempt was 7.7%, and stenting-associated mortality was 3.8% due to mispositioning of stents, leading in two cases to death. The 30-day mortality was 13.5%, and early complications occurred in 15.4%. The median survival was 216 days, and the median stent patency was 291 days. During follow-up, stent occlusion was observed in ten patients, acute cholangitis in 12 patients, acute pancreatitis in three patients, acute cholecystitis in one patient, and duodenal ulceration due to stent erosion in one patient. Routine use of biliary self-expanding metal endoprostheses by averagely experienced endoscopists can be recommended. Attention has to be paid to the correct placement of the guidewire and stent.

Aged↗
PubMed1984

Influence of long-term anticonvulsant treatment on liver ultrastructure in man.

In 35 patients on long-term anticonvulsant treatment (7-35 years, means = 19.6 years), various liver enzymes were measured. In 32 cases (91.4%), elevated levels of serum-gamma-glutamyl-transpeptidase (GGT) were found. Liver biopsy was performed in five of 13 patients with GGT levels of greater than 60 U/l (75-257, means = 123 U/l). Light microscopy showed a minimal steatosis and fine granular appearance of hepatocytes in two cases, and a slight portal fibrosis in one case. Two cases showed an unremarkable histology. Electron microscopy revealed signs of enzyme induction as overall swelling of the smooth endoplasmic reticulum and additionally a dilatation of the rough endoplasmic reticulum in all five specimens. No signs of liver damage or disturbance of liver function could be observed.

Adult↗
PubMed1983

[Side effects and safety of the new histamine H2 receptor antagonist ranitidine in the long-term treatment of patients with stomach and duodenal ulcers].

The safety and various side effects of ranitidine (2 X 150 mg daily), a new selective H2-receptor antagonist, were evaluated in the long-term treatment of patients with prepyloric or duodenal ulcer. A total of 6 adverse effects was reported by 5 out of 32 patients (18.7%). Thus, the overall incidence was low and almost half of the adverse effects involved minor or functional gastrointestinal symptoms. In no case were side effects severe enough to necessitate interruption of therapy. There were no detectable changes in haematological or biochemical blood parameters attributable to ranitidine. Long-term therapy with ranitidine appears to be safe and well tolerated; however, continued surveillance must be maintained.

Adolescent↗
PubMed1983

Endotoxaemia following colonoscopy.

In 100 consecutive patients the occurrence of bacteraemia and endotoxaemia after colonoscopy was studied. The Limulus Amoebocyte Lysate Test was used to detect endotoxaemia. No bacteraemia was detected after colonoscopy. Growth of Staph, epidermidis was considered as contamination. In 9% of the patients endotoxaemia was discovered after colonoscopy. The occurrence of endotoxaemia was found to be unrelated to the duration of the procedure, the number of the biopsies taken, or the cleansing of the bowel prior to colonoscopy. In patients with liver cirrhosis endotoxaemia occurred more often than in patients without liver disease. No clinical consequences of endotoxaemia were found in patients who developed endotoxaemia after colonoscopy. We conclude that colonoscopy is followed by endotoxaemia quite frequently. The clinical implication of these conditions, especially in patients with liver cirrhosis merits further consideration.

Adolescent↗
PubMed1983

[General characteristics and problems of the galenic aspects of fat emulsions].

The development of a clinically applicable intravenous fat emulsion has a long history. The gain of knowledge about the best lipid and emulsifying system had an intermittent development and led to three generations of distinct fat emulsions. For the evaluation of a fat emulsion it is necessary to compare the results of the same generation only. In the past, many misinterpretations came from mixing the results of different generations. It can be stated that by considering the contraindications, application schedules and basal galenic aspects, only minimal side effects from a parenteral administration of fat emulsions can be seen. Today the most important aspects of parenteral nutrition with fat emulsions are the galenic ones, which are often overlooked. The staining of the liposomes of the fat emulsions with 2% OSO4 make electron microscopic investigations of the liposomes possible after mixing them with carbohydrates, amino acids, electrolytes, vitamins and trace elements. The liposomes of soybean oil emulsions in different "All In One" (AIO) solutions have been under current investigations. The results demonstrated that the liposomes of fresh AIO-solutions carry highly osmiophilic inclusion bodies. Prolonged storage led to further alterations, as change of shape, loss of osmiophility and finally formation of liposomes ghosts. In solutions kept at 4 degrees C those changes developed between the 1st and 2nd month of storage, whereas storage at 22 degrees C was harmless within 48 h only. Therefore, it is recommended that already prepared AIO solutions are kept at 4 degrees C and used as soon as possible.

Carbohydrates↗
PubMed1982

Morphologic changes of Intralipid 20% liposomes in all-in-one solutions during prolonged storage.

Liposomes of Intralipid 20% in four solutions already mixed for total parenteral nutrition (TPN) were studied by means of a transmission electron microscope. Samples of those so-called all-in-one solutions containing all components for TPN in one bottle were taken immediately after the mixing procedure was finished, then after 24 h, 48 h, 1 week, 2 weeks, 1 month and then monthly up to 6 months afterwards. Storage was carried out for one half at 4 degrees C, for the other at 22 degrees C in darkness. The study showed that liposomes of Intralipid 20% in fresh TPN solutions decreased in their medium diameter from 0.8 to 0.6 micrometers. They carried highly osmiophilic inclusion bodies. Prolonged storage led to further alterations, as change of shape, loss of osmiophility, and lastly formation of liposome ghosts. In solutions kept at 4 degrees C those changes developed between the 1st and 2nd month of storage, whereas storage at 22 degrees C was harmful within 48 h. It is recommended, that already prepared TPN solutions should be kept at 3 degrees C and used as soon as possible, until further studies provide exact guidelines for storage time.

Drug Storage↗
PubMed1982

[Concomitant pancreatitis in hepatic coma].

Increased levels of serum amylase were found in 14 out of 34 patients (41%) with coma due to acute liver failure, in 8 out of 55 patients (14%) with hepatic encephalopathy, and in 5 out of 10 patients with a mixed pathogenesis. In 4 patients of the first group (11.7%) and 4 of the second group (7%) pancreatitis was diagnosed at post mortem. The pathogenesis of pancreatitis concomitant with liver failure is unclear. Virus infection and intoxication may do damage to both organs; hemodynamic factors, coagulation defects, and derangements of metabolism may play a role as well.

Acute Disease↗
PubMed1982

[Diagnosis of colitis in Behçet's syndrome (author's transl)].

A case report is given of a patient with Behçet's syndrome presenting with relapsing diarrhea and genital ulcers; similar cases from the literature are discussed. Neither the radiological nor the colonoscopic symptoms are typical in Behçet's syndrome and thus do not allow differentiating it from other forms of colitis. For that reason all forms of colitis accompanied by extraintestinal lesions, especially genital ulceration, should give rise to the suspicion of Behçet's syndrome.

Adult↗
PubMed1981

[Ischaemic colitis (author's transl)].

Attention must be drawn to the fact that especially in elderly patients with acute onset of abdominal pain concomitant with haemorrhagic, mucous diarrhoea, ischaemic colitis must be considered in the differential diagnosis. Ischaemic colitis arises as a consequence of insufficient blood flow through the peripheral branches of the middle colic artery and inferior mesenteric artery and mostly strikes the left colonic flexure, the colon descendens or sigmoid. Because of the segmental involvement and the macroscopic appearance on X-ray and endoscopy the disease is sometimes indistinguishable from Crohn's disease or ulcerative colitis. In every day clinical life ischaemic colitis is a relatively rare phenomenon, in spite of the high incidence of arterial occlusive disease in the patients treated at this unit. The increasing frequency of ulcerative colitis in elderly patients, as reported in the literature, may be partly associated with unidentified cases of ischaemic colitis and this possibility is discussed.

Aged↗
PubMed1977

[Myocardial involvement in a special form of Erb's muscular dystrophy (type Becker-Kiener) (author's transl)].

A 22-year-old man with cardiac symptoms had been treated for myocarditis for two years. But the clinical course and special tests, including isoenzyme measurements, electromyography, peripheral muscle and myocardial biopsy, established the diagnosis of X chromosome-linked muscular dystrophy (type Becker-Kiener) with an associated cardiomyopathy (raised left-ventricular end-diastolic pressure). Light- and electron-microscopic studies of the (right ventricular) myocardial biopsy revealed degenerative changes like those seen in peripheral muscle.

Adult↗
PubMedDate not supplied

Influence of parenteral nutrition on serum levels of proteins in patients with Crohn's disease.

Parenteral nutrition (PN) is commonly used in the management of inflammatory bowel disease. Previously we reported about the serum protein levels in Crohn's disease before and after treatment with PN; in that study we found an increase of some indicators of nutritional status and a decrease of some acute phase reactants after treatment. We have now completed the trial determining the concentration of 19 serum proteins in 25 patients with Crohn's disease before and after treatment with PN and 8 wk thereafter. The concentration of albumin, retinol-binding protein, prealbumin, and transferrin were found to rise in parallel with the body weight during PN, whereas 8 wk after treatment only albumin and transferrin showed a further significant rise. alpha-1-Glycoprotein, alpha-2-chymotrypsin, alpha-1-antitrypsin, CRP, and haptoglobin decreased during and 8 wk after PN, alpha-1-glycoprotein, alpha-2-chymotrypsin, and alpha-1-antitrypsin showed a positive correlation to the Crohn's Disease Activity Index. The serum IgM-levels were found to be significantly increased during and after PN with a negative correlation to the Crohn's Disease Activity Index. Our data indicate that PN not only improves nutritional status in the active phase of Crohn's disease during therapy but reduces the grade of inflammatory activity during and even after treatment with PN.

Adolescent↗