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Biomedical subjects

K A Koelsch

Publications and source records attributed to K A Koelsch.

At least 19 recordsLinked to original sources
PubMed1979

[Functional behavior patterns of the pylorus in duodeno-gastric reflux].

There are relations between function of the pylorus and the appearance of duodeno-gastric reflux. However, much speaks for the fact that the pylorus alone is not able to prevent duodeno-gastric reflux. In the problem of the causes of reflux also the motoric behaviour of the upper duodenum must be taken into consideration.

Bile Acids and Salts↗
PubMed1979

[Post-cholecystectomy condition: duodeno-gastric reflux and bile acid concentration in the gastric juice].

In cholecystectomized patients highly significantly more frequently a duodenogastric reflux was found than in a group of patients with a healthy abdomen and a group of patients with cholelithiasis. The average concentration of bile acid in the gastric juice was after the removal of the gall-bladder manifoldly higher than in the control groups. The number of patients with concentrated reflux was also highly significantly larger than in patients with cholelithiasis not operated on and in patients with a healthy abdomen. Despite the high reflux rate and the high concentration of the bile acids influencing on the mucous membrane of the stomach the number of patients with ulcera ventriculi was not significantly larger than in a group of not cholecystectomized persons. These observations plead for the fact that the bile acids in the duodenogastric reflux alone are not to be regarded as an ulcerogenic agent, but that perhaps other components of the duodenal juice have to be considered as causes of lesions of the gastric mucous membrane.

Bile Acids and Salts↗
PubMed1979

[Duodenitis and its correlation to diseases of the neighbouring organs and to duodeno-gastric reflux (author's transl)].

In 26,4% of patients (n = 201) with disturbances in the upper abdomen a serious proximal duodenitis was found. Older persons were more often concerned. A duodeno-gastric reflux was more frequent in presence of a serious duodenitis than in normal mucous membrane. Duodenitis was significantly more frequent in patients with atropic gastritis, ventricular ulcers and cholecystectomy. In the patients with reflux of bile the cases of antrum gastritis, with diseases of the biliary tract and nonoperated biliary tract diseases were significantly correlated with duodenitis; in atrophic gastritis as well as in gastric ulcers a duodeno-gastric reflux was found more than accidentally.

Adult↗
PubMed1978

[Polypous nonchromaffin paraganglioma of the stomach].

It is reported on the unusual position of a nonchromaffin paraganglioma in the stomach, which in gastroscopy imposed as polyp and was removed. On the basis of the light-microscopic picture, its behaviour during staining and the electronmicroscopic investigations the tumour is classified in the group of the paragangliomata. Since there are no unequivocal histological criteria of malignity, on account of the well-known slow growth of these tumour only the polyp is removed.

Diagnosis, Differential↗
PubMed1976

[Learning gastroenterologic endoscopy].

1. Knowledge of the gastroenterological endoscopy and biopsy is necessary at all levels of medical education. 2. Knowledge of students: possible methods, diagnostic effectiveness, stress of the patients. Knowledge of the candidates for specialisation: indications, contraindications, possibilities of the method also in reference to the individual case. Persons interested in the subspecialisation gastro-enterology: theory, possibilities and limits, technical performance. Experienced endoscopists: regular refreshment and supplementation of knowledge and skill in highly specialised endoscopic centres. 3. Tested teaching methods are lecture, report, study of atlants and text-books, demonstrations of diapositives in connection with schematic figures, seminars with diapositives, film demonstrations, work at the patient under supervision of the tutor and use of a demonstration device as well as endoscopic demonstration by means of colour television. The centre is, however, the individual examination of the patient. 4. Knowledge of the subspecialist: History of endoscopy, knowledge of instruments, optics and endoscopic perspective, physical fundaments about light and photography, human macro- and microscopic anatomy, care of instruments and desinfection. Indications, contraindications, possibilities and limits of the method, emergency and intensive medicine, writing of the findings.

Disinfection↗
PubMed1976

[Stress ulcer; origin and treatment (author's transl)].

Conditions like stress and shock influence each other and lead to irritation of the regio hypothalamica not only in its anterior but also in its posterior part with excitement of the n. vagus or the anterior lobe of the hypophysis respectively (ACTH-release with following release of cortisole). Irritation of the n. sympathicus and diminution of the circulating plasma volume are additional sides of the pathophysiological course. Sequels of this are: reduction of blood flow through the gastric mucosa, decrease of the protective ability of the mucus, secretion of an especially aggressive gastric juice and reflux of bile into the stomach. They lead to a breakdown of the mucosa barrier with releasing of histamine in the mucosa, to peptic, destruction of the gastric walls damaged regions and thus to the development of erosions and acute ulcers (AGML=acute gastric mucosal lesions). As to the aspect, these ulcers cannot be differentiated from those lesions of the mucosa which are induced by medicaments. To recognize a complicating hemorrhage in time an emergency endoscopy is recommended. Complicated perforations are seldom observed. Prognosis is bad in patients with complications. Therefore prophylactical measures are of special importance like vagotomy, medicamental blockade of the n. vagus and influencing of the n. sympathicus, infusions in time and in sufficient extent, application of anti-acida and, in case of bile reflux, cholestyramin. Therapy of hemorrhage should be made according to the endoscopical findings. Conservative therapy should be the first aim. If surgical therapy cannot be avoided, methods of minimal risk should be practised.

Anti-Ulcer Agents↗