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Biomedical subjects

L Wannagat

Publications and source records attributed to L Wannagat.

16 recordsLinked to original sources
PubMed1981

[Prognosis of portal hypertension in hepatitic cirrhosis of the liver (author's transl)].

Laparoscopic transhepatic measurement of pressures in the branches of the portal vein (and hepatic vein) were performed in 42 patients with hepatitic cirrhosis of the liver and compared with those obtained in patients with other defined causes of cirrhosis (alcohol, pigment, Budd-Chiari syndrome, right heart failure). Mean portal vein pressure was 27.2, mean hepatic vein pressure 14.5 mm Hg. A significant pressure difference (Kruskal-Wallis test) was present only between hepatitic cirrhosis and congestive cirrhosis, not alcohol or pigment cirrhosis. During the period of observation (1975-1978) there was a high incidence of deaths and complications in the hepatitic group compared with other forms of cirrhosis: 6 treatment-resistant and 2 successfully treated cases of bleeding from oesophageal varices. The risk of bleeding begins at a pressure above 27 mm Hg, but in individual cases it cannot be used to prognosticate.

Female↗
PubMed1981

Laparoscopic transhepatic manometry in portal hypertension in patients with alcoholic liver damage.

Liver damage influenced by alcohol is already associated with the development of a portal hypertension at an early stage. With the aid of laparoscopic transhepatic manometry we determined the pressure levels in the branches of the portal and hepatic veins in 15 patients (16 examinations) comprising 14 men and 1 women, with alcoholic toxic liver damage. It was shown that already with alcoholic parenchymal damage associated with portal and centrolobular fibrosis, a portal hypertension is initiated, the greatest manifestation of which is found in the group with histological changes taking the form of a remodelling (distorsion of architecture) or cirrhosis. The level of alcohol consumption has no direct influence on the level of pressure in the vascular systems investigated. Ther is, however, a correlation between the level of alcohol consumption, extent of fibrosis and portal hypertension. For the clinico-chemical parameters investigated (Gamma-glob., GOT, GPT, GLDH, gamma-GT, alkaline phosphatase, bilirubin) no significant differences were found dependent on the level of alcohol consumption or the degree of fibrosis.

Adult↗
PubMed1980

Portal hypertension in chronic hepatitis--comparative manometric and clinico-chemical examinations.

Portal hypertension (PH) which, for patients suffering from chronic liver disease, usually determines their subsequent fate, considerably exceeds the upper limit already in chronic hepatitis. With the aid of laparoscopic transhepatic manometry (LTM) in the branches of the portal and hepatic veins we measured portal vein pressures of 17.7 and hepatic vein pressures of 12.3 mm Hg in patients with chronic persistent hepatitis (CPH). In patients with chronic aggressive hepatitis (CAH) with still only moderate fibrosis, the pressure was 18.8 (in the portal vein) and 11.0 mm Hg (in the hepatic vein) while in CAH with marked remodeling, the average pressures were 19.9 and 11.8 mm Hg respectively. The early elevation of the PH, also in CPH, is an important indication for a thorough diagnostic work-up and "aggressive" therapy of the CH.

Blood Pressure Determination↗
PubMed1980

[Portal hypertension in chronic hepatitis (author's transl)].

Portal hypertension as the basis of threatening complications determines the subsequent fate of many patients with chronic inflammatory diseases of the liver. Normal values are exceeded considerably already in chronic hepatitis, but critical levels of pressure--with respect to the danger of bleeding from oesophageal varices--are only attained when cirrhotic remodelling is complete. With the aid of laparoscopic transhepatic manometry (LTM), we measured the levels of pressure in the branches of the portal vein and the hepatic vein in 23 patients suffering from chronic hepatitis (CH). In patients with chronic persistent hepatitis (CPH), the pressure in the portal vein was 17,7, in the hepatic vein 12,3 mm Hg (n = 4). In a group of 15 patients presenting with chronic aggressive hepatitis (CAH) with marked remodelling extending to cirrhosis, the average pressures were 19,9 and 11,8 mm Hg respectively; in four patients with CAH and, as yet, only slight fibrosis, the corresponding figures were 18,8 and 11,0 mm Hg respectively. In view of the recorded incidence of bleeding in 42 patients with complete hepatic cirrhosis, the early detection and intensive treatment of CH is of particular importance.

Adult↗
PubMed1979

[Portal hypertension associated with alcoholic liver damage (author's transl)].

Alcoholic liver damage is associated with the development of portal hypertension quite early, as a result of increasing fibrosis. By means of laparoscopic transhepatic manometry (LTM) in the branches of the portal and hepatic veins, we measured the pressure levels in 15 patients with early and transitional-stage alcoholic injury extending to cirrhosis of the liver, and compared them with histological and laboratory investigation criteria. We discovered that parenchymal damage with portal and centrolobular fibrosis already gave rise to some portal hypertension which, compared to a group showing histological changes of remodelling or cirrhosis, constantly increased. In completely developed alcoholic cirrhosis (n = 41), the pressure levels reached a peak. Despite this fact, bleeding from oesophageal varices cannot be predicted. Over the period of observation of 33 months, 4 deaths occurred (portal vein pressure between 4.5 to 5 kPa = 34.0 to 38.8 mm Hg), and three variceal bleedings we were able to manage were seen (pressures between 3.6 to 4.3 kPa = 27.0 and 32.0 mm Hg). Compared to hepatitic cirrhosis the prognosis was slightly more favourable.

Adult↗
PubMed1979

[Portal hypertension in idiopathic haemochromatosis (author's transl)].

In contrast to hepatic and alcoholic cirrhosis of the liver, the life-threatening portal hypertension seen in idiopathic haemochromatosis (IH) responds well to therapy. With the aid of laparoscopic transhepatic manometry, we determined the pressures in the branches of the portal vein and the hepatic vein in four patients presenting with IH, and compared the values obtained with clinico-chemical and histological parameters. Three patients who had been suffering from the disease for periods varying between two and ten years, responded well to therapy. The fourth patient, who presented with the highest pressure in the portal vein (26.5 mm Hg) died, three months after the initial establishment of the diagnosis of advanced IH, in consequence of unmanagable haemorrhage from oesophageal varices.

Hemochromatosis↗
PubMed1975

[Segmental angiography of the liver with laparoscopy and electro-coagulation. Selective hepatography (author's transl)].

Segmental angiography of the liver with laparoscopy and electro-coagulation has high diagnostic value. The circulatory systems of the liver may be studied selectively or in various combinations. Morphologic lesions as well as functional disturbances of liver arteries and veins, the portal vein and to a certain degree lymph vessels can be visualized precisely. An improved indication for shunt operations and a more reliable prognosis may be achieved by direct transhepatic pressure measurements, especially within the hepatic artery and portal vein. An early diagnosis of the Budd-Chiari-Syndrome is enabled by the combined segmental veno- and portography which could not be achieved by the known techniques so far. Complications are rarely seen. In 1070 examinations there was one suspicion for bilihemia, one case of hemobilia, and one case of a subcapsular hematoma. Twice a liver lobe was perforated. There was never a permanent damage to the patient. Biochemical and nuclear medicine studies are suggested.

Adult↗
PubMedDate not supplied

Reflections on cancer therapy.

A schedule for treatment of cancer patients with low-dose combined chemotherapy infusions is presented for discussion. This schedule is designed to activate the immune system. Active agents such as mistletoe preparations etc. which are at present still controversial, balneological applications, diet, ethics and nursing home facilities are mentioned. Finally the question is raised as to whether it may be appropriate under certain circumstances in the individual case to institute abortive cytostatic treatment even in suspicion of a cancerous condition, i.e. at a time when the organ diagnosis has not yet been substantiated.

Antineoplastic Combined Chemotherapy Protocols↗