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Biomedical subjects

H Wenzel

Publications and source records attributed to H Wenzel.

At least 37 records · Page 2Linked to original sources
PubMed1990

Antihypertensive treatment in Germany, subjected to a cost-effectiveness analysis.

German physicians are increasingly adopting national and international recommendations on the promotion of non-pharmacological treatment of elevated blood pressure. This reflects a greater sensibility to the advantages and disadvantages of antihypertensive drugs versus dietary means. Furthermore, the rapid growth of health expenditure is a central issue in many policy decisions. Increasingly, the use of cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA) is being advocated as a possible means of making the medical care system more efficient. We report an analysis of the value of treating hypertension in Germany-West.

Aged↗
PubMed1989

[Extracorporeal shockwave lithotripsy of bile duct stones].

Extracorporeal lithotripsy (EL) was undertaken in 50 patients (mean age 73.7 years; range 29-90 years) with extrahepatic and, in five, with intrahepatic gallstones, the usual endoscopic methods having been unsuccessful in removing the stones. Occasionally stone fragments were passed spontaneously, but in most they had to be removed endoscopically, in 48 (96%) with extrahepatic and in three (60%) with intrahepatic stones. Biliary tract or gallbladder infections occurred after the lithotripsy and associated local litholysis in seven of the 48 with extrahepatic (14%) and three of the five (60%) with intrahepatic stones. There was one hospital death. The results indicate that EL has definite advantages over surgical treatment in these patients, who are usually elderly and in whom surgical intervention is more risky.

Adult↗
PubMed1989

[Effect of omega-3-fatty acids on biliary lipids and lithogenicity].

Until now no studies are available about the influences of omega-3-fatty acids on biliary lipids in men. The effects of 1.5 g omega-3-fatty acids per day on biliary lipid concentration and composition were studied in 13 male healthy persons over six weeks. Biliary cholesterol concentration decreased from 5.4 +/- 0.53 mol% to 3.7 +/- 0.30 mol% (25%) statistically significant. Phospholipids and bile acids remained unchanged. Cholesterol saturation index (CSI) was lowered from 1.13 +/- 0.12 to 0.85 +/- 0.06 (p less than 0.05). Bile acid composition and conjugation rates were unchanged. No significant side effects could be observed. Substitution of omega-3-fatty acids induced in healthy male persons a decrease of biliary cholesterol and lithogenicity.

Adult↗
PubMed1989

[Changes in biliary lithogenicity caused by 4 weeks' weight reduction].

In 2 of 12 patients (16.6%) cholesterol monohydrate crystals occurred in duodenal bile samples after a 4 weeks fasting period (452 kcal/day). Cholesterol monohydrate crystals could be observed until recently mainly in patients with cholesterol gallstones. Therefore, this finding indicates increased biliary lithogenicity despite a non statistical decrease in CSI from 1.35 +/- 0.35 to 1.19 +/- 0.64. Presumably the increased lithogenicity may be caused by an increased glycoprotein concentration and an improvement in gallbladder contractility. Short time fasting obviously will be a risk factor for the development of gallstones, if weight and metabolic normalisation cannot be achieved.

Adult↗
PubMed1988

[Dietary modification of bile lipids].

The average incidence of gallstones in european countries is about 25%. Excessive secretion of cholesterol into the bile can predispose to saturation and gallstone-formation. Obesity, overnutrition, diets rich in refined carbohydrates, diets high in cholesterol intake and poor in dietary fibre, lipid lowering drugs, age and female sex hormones are recognized causing increased cholesterol secretion into the bile. These metabolic consequences may predispose to a higher incidence of cholesterol gallstone than in normal persons. Taking all the results of the literature together patients with gallstones should be encouraged to take a low cholesterol, low calorie, low refined carbohydrate and high polyunsaturated fat diet rich in bran und vegetable fibre. Obese patients should reduce their body weight. These dietary recommendations should be given for patients with gallstones during bile acid therapy and after successful dissolution in order to prevent gallstone recurrence.

Bile↗
PubMed1987

[Biliary shock-wave lithotripsy. Fragmentation and lysis--a new procedure].

Between September 1986 and April 1987, extracorporeal shock-wave lithotripsy, supplemented by oral chemolitholysis, was undertaken on 157 patients with symptoms of gallstones. Partial or complete stone fragmentation was achieved in 148 (94.3%). Freedom from stones was maintained under continuous chemolysis treatment for an average observation period of 8.5 weeks in 31 (19.7%). Considerable fragment reduction was obtained in 97 (61.8%), of whom 26 (16.6%) were demonstrated to have only minimal stone residues. Insufficient fragmentation and (or) no response to litholysis occurred in 29 (18.5%). These preliminary results suggest that, if there are moderately sized (less than 25 mm) and only a few (1-3) noncalcified cholesterol stones, these two methods in combination promise to be an effective alternative to cholecystectomy.

Adult↗
PubMed1987

Influence of increased fibre intake on biliary lipids.

Influence of increased fibre intake on biliary lipids. The influence of dietary fibres (30 g wheat bran per day) on the lithogenicity of the bile was studied in ten healthy persons, whose body weight was 76.8 +/- 2.3 kg, height 189.9 +/- 2.1 cm, age 25.5 +/- 0.26 years. These 10 young male volunteers were given twice daily 15 g wheat bran additionally for six weeks in addition to their normal diet. The bile was obtained endoscopically prepapillarily following stimulation of the gallbladder with ceruletid. The contraction of the gallbladder was controlled sonographically. Increased dietary fibre intake resulted in significant lowering of cholesterol concentration in the bile from 3.27 +/- 0.89 mmol/1 to 2.50 +/- 0.67 mmol/1. The lithogenic index (Admirand and Small, 1968) decreased statistically significant from 1.01 +/- 0.14 to 0.67 +/- 0.11. Total cholesterol and HDL and LDL cholesterol remained unchanged; likewise, there was no change in serum triglyceride and phospholipid concentrations. Hence, an increased intake of dietary fibres of the wheat bran type should be the first dietary measure in both prevention and treatment of cholesterol gallstone disease.

Adult↗
PubMed1986

[Sonography of gallbladder calculi: possibilities and limits in the selection of gallstone patients suitable for conservative lysis].

The sonographic patterns of artificially produced pure cholesterol and pigment gallstones were evaluated in vitro. Cholesterol calculi exhibited a smooth echo with a relatively high beam penetration, whereas pigment calculi showed a sickle-like surface echo without beam penetration. Clinical evaluation of these criteria in 107 patients was based on correlating preoperative sonographic diagnosis with postoperative microchemical analysis of the calculi. Although small, smooth cholesterol calculi were detected via ultrasound with an accuracy of more than 90 percent, pigment calculi could not be separated and identified with satisfactory precision.

Adult↗
PubMed1985

[Accuracy of ultrasound-guided fine needle biopsy in pancreas cancer--effect of puncture frequency and character of puncture material].

There is no agreement upon the number of punctions guided by ultrasonography needed to establish cytologically the diagnosis of pancreas carcinoma. Therefore reliability of the method as being dependent upon the number of punctions in 43 maligne tumors of the pancreas was evaluated. Performing two to five punctions yielded significantly better results than just one. In addition the macroscopic aspect of the aspirate is important.

Biopsy, Needle↗
PubMed1984

[Wheat bran-type roughage reduces the lithogenicity of bile].

The effect of 30 g wheat bran on the lithogenic potency of bile was studied in ten healthy males (age 25.5 +/- 0.76 years; height 182.9 +/- 2.1 cm, weight 76.8 +/- 2.3 kg). Wheat bran was taken for over six weeks, at 15 g twice daily. Bile fluid was sucked out from the prepapilla after bile stimulation. Contraction of the gallbladder was checked by ultrasound. Concentration of total bile acids and bile acid spectrum, as well as the concentration of phospholipids, remained unchanged for the six weeks of increased wheat bran intake. Cholesterol concentration in bile decreased from 3.27 +/- 0.89 mmol/l to 2.50 +/- 0.67 mmol/l. The lithogenic index fell from 1.01 +/- 0.14 to 0.67 +/- 0.11. Concentrations and composition of lipids and lipoproteins in serum remained unchanged. An increased intake of wheat bran was thus shown to be a decisive dietary measure in the prevention and treatment of cholesterol gallstones.

Adult↗
PubMed1984

[Dissolution of recurrent stones in the choledochus by a modified irrigation treatment via an indwelling nasobiliary catheter].

Alternating fluid rinsing with a modified glyceromono-octanoate (GMOC) and bile salt-EDTA (BA-EDTA) solution via an endoscopically placed indwelling nasal biliary catheter was performed on 15 patients (13 women, 2 men) with recurrent stones in the choledochal duct after cholecystectomy. Of 12 radiotranslucent and three radioopaque concrements with a mean diameter of 1.72 X 2.05 cm (largest concrement: 3.0 X 3.5, smallest 1.0 X 2.1 cm) 13 were dissolved (87% success rate). In one patient chemolitholysis had to be stopped because of electrolyte abnormalities, before treatment had been completed. After the end of treatment all patients were free of symptoms and during a fairly long follow-up period no stone recurrences were observed.

Aged↗
PubMed1984

[Modified fasting in the therapy of obesity. A comparison of total fasting and low-calorie diets of various protein contents].

Modified fasting represents a successful therapy for obesity without severe side effects. The daily energy-substitution (1000-1700 kJ) consists of 30-50 g high quality protein, 20-40 g carbohydrates and small amounts of fat. The mean weight loss is 11-14 kg in a four-week treatment period. In contrast to total fasting the weight loss achieved with modified fasting consisted in a percentage of 79% adipose tissue and a minimal protein loss of 3%. The nitrogen equilibrium was reached after one to three weeks thus avoiding the risks of greater protein losses.

Diet, Reducing↗
PubMed1984

Nitrogen balance studies during modified fasting.

Protein or nitrogen depletion may be harmful and deleterious as reports of deaths in obese patients fed by liquid protein diets have shown. The aim of our studies was to determine the protein losses (by urinary nitrogen losses) during treatment of obesity with modified fasting over four weeks under inpatient conditions. Sixty-one patients were treated in our metabolic ward with modified fasting randomized into four groups. The daily diet consisted of 33-50 g protein/day, 1-10 g fat/day and 25-45 g carbohydrates/day thus providing 240 to 450 kcal/day or 1.0 to 1.9 MJ. The mean weight losses ranged between 11.0 +/- 0.7 kg and 13.9 +/- 0.9 kg in 28 days. The acceptability and compliance of the four applied diets were excellent and no severe side effects could be observed. The nitrogen balances could be equilibrated from the third week on. The composition of weight lost during modified fasting was as follows. The percentage of body protein ranged between 3% and 16% and the percentage of adipose tissue between 63% and 79% of the total weight loss. Therefore modified fasting represents a very effective and safe therapy of massive obesity.

Adipose Tissue↗