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Biomedical subjects

H Pristautz

Publications and source records attributed to H Pristautz.

At least 19 recordsLinked to original sources
PubMed1992

[Kala-azar acquired in Croatia].

Six weeks after his return from a two-week vacation in Croatia a 52 year-old janitor from Graz complained of loss of appetite, fever, headache, and a 9-kg weight loss. The spleen was enlarged to 16cm as measured by sonography. Laboratory tests revealed pancytopenia, a prolonged prothrombin time and elevation of serum LDH concentration. While repeated bone marrow biopsy showed no signs of leishmaniasis, high antibody titers against leishmania antigen led to the diagnosis of kala-azar. The indirect immunofluorescent antibody test (1:128) and a haemagglutination-inhibition test (1:512) showed diagnostic elevations of titers. Therapy with pentostam led to prompt defervescence and resulted in a full recovery of the patient. After six weeks a marked decrease of antibody titers in the haemagglutination-inhibition test (1:16) could be observed. Leishmaniasis has to be considered in patients with fever of unknown origin who return from Mediterranean countries. Despite a negative bone marrow biopsy a diagnosis is possible on the basis of serological tests. This is important because effective therapy is available as illustrated by this patient and because of the fact that the disease runs a lethal course if the diagnosis is missed.

Animals↗
PubMed1992

Diagnostic problems in nodular regenerative hyperplasia (nodular transformation) of the liver. Review of the literature and report of two cases.

Nodular regenerative hyperplasia (NRH) is a rare lesion of the liver associated with portal hypertension in more than half of patients. We present two cases demonstrating complications and diagnostic problems of NRH and review the pathogenesis, clinical, radiologic, and pathologic features of 240 cases in the literature. Patient 1 died from variceal bleeding as a complication of NRH. Patient 2 presented with ascites. Sonographic, computed-tomographic and magnetic resonance findings did not differ from liver cirrhosis. Three needle biopsies showed nonspecific reactive hepatitis. Wedge liver biopsy provided the correct diagnosis of NRH and a shunt operation was performed. Non-Hodgkin's lymphoma (centroblastic type) was diagnosed three years after NRH. At present there is no clinical or radiologic evidence of progression of NRH in this patient. The diagnosis of NRH cannot be made without histologic examination. Correct diagnosis is difficult in percutaneous needle biopsy. Therefore, laparoscopically guided liver biopsy or wedge biopsy is often necessary for diagnosis. NRH should be included in the differential diagnosis of portal hypertension. Portal diversion can be considered.

Biopsy↗
PubMed1991

[Extracorporeal shockwave therapy in giant stones in the common bile duct--a case report].

A huge common bile duct stone of 6 to 3 cm in diameter in a 64 year old lady was approached by ESWL, after endoscopic therapy such as mechanical lithotripsy and removal with the Dormia basket had failed because of the extraordinary size of this stone. A surgical therapy was not possible because of pronounced vascular and cardiopulmonary risk, so ESWL was applied to this patient. The stone was fragmented in two sessions of ESWL under sonographic targeting and the fragments were removed endoscopically. After one month one fragment still remained in the common bile duct, which then was removed also endoscopically. Two months later the ERC showed a stone-free common bile duct. This case demonstrates, that even common bile duct stones of extraordinary size can be removed by combining ESWL with endoscopic techniques. Following the trend to minimally invasive therapy, sonography should be preferred over XRay in diagnosis before ESWL as well as during ESWL.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1990

One-year treatment of chronic non-A, non-B hepatitis with interferon alfa-2b.

Thirty patients with chronic non-A, non-B hepatitis (24 male, six female; median age 38 years, range: 15-68 years) were treated with recombinant interferon alfa-2b for 1 year. Treatment was started with 5 million units interferon alfa-2b daily for 2 weeks followed by 2 million units daily for another 2 weeks. Further doses were titrated according to alanine aminotransferase values. After 1 year, treatment was stopped and a follow-up biopsy was obtained. Thereafter, patients were followed for 6 months. Of the 24 patients who completed the 1-year treatment period, 14 (58%) had normal alanine aminotransferase values at the end of the study, eight of whom showed transient increases while on treatment. In another seven (29%), alanine aminotransferase levels decreased by more than 50% of pre-treatment values but remained above the normal range. Biopsies at the end of treatment showed a complete disappearance of inflammatory activity in four and a marked improvement in eleven other patients. The results of this study indicate that a 1-year treatment with recombinant interferon alfa-2b of patients with non-A, non-B hepatitis was very effective at normalizing or improving serum transaminases and liver histology. However, the overall relapse rate was 57%, with relapse occurring in a greater proportion of patients with temporary breakthroughs during therapy (requiring dosage increase), and particularly of patients with only a partial response to treatment (serum transaminases decreased by greater than or equal to 50%). Thus, further studies are needed to establish the optimal dose and duration of treatment to induce a complete resolution of the disease.

Adult↗
PubMed1990

[Cowden syndrome].

A patient with multiple hamartoma syndrome or Cowden's disease with multiple gastrointestinal polyps and malignant melanoma is presented. The syndrome is characterized by hamartomatous tumors of the skin, fibrocystic disease of the breasts, gastrointestinal polyps and disease of the thyroid gland such as goiter and adenoma. In addition, other abnormalities and malformations occur in the skeletal system, central nervous system and urogenital tract. Recognition of this syndrome is important because of the association with malignant tumors of the breast and thyroid gland and with malignant melanoma. Gastrointestinal hamartomatous polyps may lead to the diagnosis of Cowden's disease which must be separated from other intestinal polyposis syndromes.

Adenomatous Polyposis Coli↗
PubMed1989

[Whipple's disease: abdominal lymphoma, intermittent fever and recurrent arthralgias].

A diagnostic laparotomy was performed on a 41-year old woman who, having suffered from recurrent arthralgias for several years and intermittent fever for many months, was found to have extensive enlargement of abdominal lymph-nodes, raising the suspicion of malignant lymphoma. Frozen-tissue biopsy was highly suspicious of Hodgkin's lymphoma, but light- and electron-microscopy revealed Whipple's disease, confirmed in an endoscopically obtained duodenal mucosal biopsy. The arthralgia quickly responded to antibiotic treatment. This case demonstrates the potential difficulties and errors in the diagnosis of Whipple's disease.

Abdominal Neoplasms↗
PubMed1989

[Sonography and cytology of cold thyroid nodules].

270 patients with a scintigraphically cold thyroid nodule of sonographically increased (n = 34), diminished (n = 72) or neutral (n = 86) echogenity or cystic criteria (n = 78) were subjected to fine needle aspiration biopsy. This revealed unequivocal malignancy in 8 and follicular neoplasia in another 30 patients, 10 of whom proved to have malignomas on further evaluation. A total of 12 papillary and 2 follicular carcinomas, 2 non-Hodgkin lymphomas, 1 sarcoma and the metastasis of a breast carcinoma were diagnosed. The most sensitive criteria for malignancy were diminished echogenity, an inhomogeneous echo pattern and the occurrence of a solitary nodule. The incidence of malignancy was increased among males but not among especially young persons. There was no sonographic feature that would permit omission of fine needle aspiration.

Adenocarcinoma↗
PubMed1988

[Serum bile acids in diffuse liver parenchymal damage and their relation to ultrasound diagnosis].

40 patients with sonographically detected diffuse liver diseases of different severity and 8 controls with normal ultrasound of the liver were evaluated for fasting concentrations of serum bile acids (SBA) using an enzymatic method. Differences of SBA levels were significant among 4 groups classified as to severity by ultrasonography; SBA levels above 4.6 mumol/l were specific for the more severe grades of liver disease. Measurement of SBA and the evaluation of echographic patterns may be helpful in the decision to perform a liver biopsy.

Bile Acids and Salts↗
PubMed1987

[Pathologic enzyme patterns in sonographically verified liver metastases].

The serum enzyme pattern, consisting of GOT, GPT, lactate dehydrogenase, gamma glutamyl transpeptidase and alkaline phosphatase, was investigated in 128 patients with sonographically verified liver metastases. Gamma glutamyl transpeptidase and alkaline phosphatase turned out to be the most sensitive enzymes, being elevated in 89% and 88%, respectively. The GOT was elevated in 45% GPT in 37.5% and lactate dehydrogenase in 56% of all cases. The enzyme elevation did not correlate with the degree of liver involvement. In conclusion, pathological serum enzyme patterns are useful for the detection and follow up of liver metastases. Normal serum enzyme levels do not rule out the presence of liver metastases.

Enzymes↗
PubMed1987

[Is sonography superior to enzyme diagnosis in the detection of hepatic steatosis?].

In order to evaluate the diagnostic value of sonography in steatosis of the liver, liver biopsies were performed in 52 patients with sonographically diagnosed steatosis of the liver. 27 of 28 patients with normal serum enzymes showed an estimated steatosis of 10 to 40% on histological examination. In the other 24 patients with increased serum enzyme levels histological steatosis was found in 20 patients. 8 further patients with presumed systemic disorders had both normal sonographic findings and normal serum enzyme levels and when subjected to liver biopsy showed an estimated steatosis in the range of 5 to 10%. Reliable sonographic diagnosis of steatosis of the liver can be made only if the degree of steatosis exceeds 10% at least. Normal serum enzyme levels do not exclude steatosis of the liver.

Enzymes↗
PubMed1986

[Sonographic comparative studies of the portal vascular system before and following endoscopic sclerosing of esophageal varices].

On the occasion of 35 episodes of oesophageal injection therapy in which partly the intravascular and partly the perivascular injection technique were used, real time sonographic measurements were performed on the veins of the portal system immediately before and after sclerotherapy. In the case of intravascular injection, both the portal and the splenic vein and the confluens of the splenic and the superior mesenteric vein showed an increase in diameter, whereas in the cases of perivascular injection such changes were minimal or absent. The practical applicability of such sonographic calibrations could possibly lie in certain conclusions that could be drawn concerning the degree of vascular compression or obliteration during each session of sclerotherapy.

Esophageal and Gastric Varices↗
PubMed1986

[Effect of celiprolol and metoprolol on serum lipids in patients with various forms of hyperlipoproteinemia].

In a single-blind prospective study, patients with hyperlipoproteinemias of the types II a, II b or IV were examined for changes of their serum lipid levels under the treatment with 300 mg celiprolol or 200 mg metoprolol, respectively, for a period of 4 weeks. Celiprolol led to a reduction of serum triglycerides, while the total cholesterol level remained practically unchanged; the HDL-cholesterol level rose from an average of 41.7 to 53.9 mg/dl (p less than or equal to 0.05). There was a slight increase of the LDL-cholesterol level and a significant decrease of the quotients between LDL- and HDL-cholesterol and between total cholesterol and HDL-cholesterol. Metoprolol caused a slight increase of the serum triglycerides, the total cholesterol level remained unchanged, while the HDL-cholesterol level slightly increased from 56.7 to 59.3 mg/dl. The level of LDL-cholesterol and the quotient between LDL-cholesterol and HDL-cholesterol decreased slightly. On the contrary, the quotient between total cholesterol and HDL-cholesterol remained practically unchanged. Celiprolol had a favourable influence on the serum lipid pattern, as far as the atherogenic risk is concerned.

Adrenergic beta-Antagonists↗
PubMed1985

[Differential diagnosis and therapy possibilities of hematochezia in elderly patients].

In a survey the differential diagnosis and the exploratory and therapeutic possibilities in massive colonic hemorrhage are discussed. In elderly patients the most frequent sources are diverticular hemorrhage and bleeding angiodysplastic lesions. Scintigraphy is the least invasive method of localizing the source of bleeding. Angiography presents, apart from diagnosis, therapeutic possibilities such as embolization or intraarterial administration of vasopressin. In case of failure of conservative treatment hemicolectomy is indicated.

Aged↗
PubMed1985

[Significance of pancreatic polypeptide in gastrointestinal diseases].

Release of pancreatic polypeptide (PP) into blood by pancreatic PP cells is closely correlated with pancreatic exocrine secretion and is thus stimulated by food intake. PP causes inhibition of exocrine pancreatic secretion and bile acid output. In insufficiently treated diabetics elevated basal and postprandial serum levels of PP are found, which return to normal when adequate treatment is administered. In patients with autonomous diabetic neuropathy insulin induced hypoglycemia leads to subnormal increases of serum PP levels. Low PP secretion is found in chronic pancreatitis only when pronounced pancreatic insufficiency is observed. In patients with duodenal ulcus significantly elevated but also normal serum PP concentrations were found. Endocrine active pancreatic tumors may cause highly increased PP levels together with other hormones and elevated serum PP levels may be used as a diagnostic indication in such rare cases. However the determination of PP serum levels is not suited as a routine diagnostic method.

Blood Glucose↗
PubMed1985

Influence of calcitonin on serum levels of pancreatic polypeptide in man.

In groups of 8 patients each, the increases in pancreatic polypeptide (hPP) serum level were measured after a protein-rich test-meal; one group received an infusion of 200 IU Salmon-calcitonin for a period of 3 hour while the other group did not. Calcitonin causes a significant inhibition of both the basal and the stimulated hPP serum level. Among the patients who did not receive a calcitonin infusion, the stimulated values after 15 to 120 minutes were significantly higher than the initial values, while patients receiving calcitonin did not show a significant increase. With calcitonin, the area under the secretion curve was 43% smaller. yet, on the basis of our results, the known gastrointestinal effects of calcitonin on pancreas secretion cannot be completely explained by the observed inhibition of hPP secretion.

Adult↗
PubMed1984

[Diabetic coma].

The diabetic coma presents a metabolic derangement which is initiated by a lack of insulin but is markedly enhanced by intracellular insulin resistance. The most essential points of insulin, fluid and electrolyte substitution are presented in this publication. Intensive care treatment is recommended not only because of the severe metabolic defect but also because of disturbances coming up in the course of treatment.

Central Venous Pressure↗
PubMed1984

[Acute pancreatitis].

The acute pancreatitis, especially the more severe cases with tissue necrosis, requires a high degree of intensive care monitoring and treatment. For the determination of the most suitable moment for surgical intervention, close cooperation between internist and surgeon is inevitable. The initial therapy is principally conservative; in especially severe cases and in cases of biliary pancreatitis, an early operation may be necessary, whereas in most cases of grade II pancreatitis, delayed surgery will be performed. Prerequisite for the success of any operation is optimal pre- and postoperative medical treatment.

Acute Disease↗