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Biomedical subjects

M Classen

Publications and source records attributed to M Classen.

At least 325 records · Page 18Linked to original sources
PubMed1985

[Endoscopic ultrasonic study of the esophagus].

Endoscopic ultrasonotomography opens a sonographic window to the organs of the mediastinum. With this technique all segments of the oesophagus can be sonographically investigated. Endosonographic investigations on 11 patients with oesophageal tumors and 3 patients with oesophageal varices showed that the diagnosis of oesophageal carcinoma and differentiation between malignant tumors and benign changes are possible. The spread of the tumor in the horizontal and vertical planes can be accurately determined with endoscopic ultrasonography. In addition, paraoesophageal lymph node metastases, as well as other lesions in the mediastinum, can be diagnosed. Ultrasonography of the oesophagus can be simplified by leaving out the optical system.

Carcinoma, Squamous Cell↗
PubMed1985

[Healing rates following omeprazole and ranitidine treatment of gastric ulcer. Results of a German multicenter study].

The effectiveness of omeprazole (20 mg orally each morning) or ranitidine (150 mg orally twice daily) in the treatment of gastric ulcer was compared in 184 out-patient in a randomized, endoscopically controlled multi-centre double-blind ("double dummy") trial. Healing rates with omeprazole after two, four and eight weeks were 43, 81 and 95%, respectively, those with ranitidine were 45, 80 and 90%, a statistically not significant difference. Independently of medication, small ulcers (less than 8 mm diameter) healed more quickly than larger ones. Ulcers in the body of the stomach responded poorest to both drugs. Smoking had no statistically significant effect on healing rate. Omeprazole and ranitidine had similarly favourable effects on symptoms. Neither side effects nor changes in biochemical parameters could be ascribed to omeprazole. Both drugs had equivalent effects on the healing of gastric ulcers in the stated dosages.

Adult↗
PubMed1985

[Rectoscopy: rigid or flexible? A comparative study].

The customary rigid rectoscope was compared prospectively, with a new, flexible one (prototypes of Olympus Opt. and Fuji) in each of 114 patients selected at random. Maximal depth of introduction was reached on average after 1 min with the rigid instruments, after 1 min 40 sec with the flexible one. Mean depth of introduction was 16 cm for the rigid and 33 cm for the flexible one. In 21 patients (18.4%) additional information was obtained with the flexible rectoscope. 80% of patients reported that the flexible instrument caused them no or only slight discomfort. Skill in using the flexible instrument can be quickly acquired.

Fiber Optic Technology↗
PubMed1985

[Short-term therapy of duodenal ulcer with omeprazole and ranitidine. Results of a German multicenter study].

In a randomized, endoscopically controlled double-blind trial the effectiveness of a single oral, morning dose of 40 mg omeprazole was compared with a twice daily oral dose of 150 mg ranitidine given to 334 ambulatory patients with duodenal ulcers. Under omeprazole 105 of 146 duodenal ulcers were demonstrated to have healed within 14 days (72%), compared with 95 of 160 (59%) on ranitidine. The difference is statistically significant (P = 0.0121). After 14 days smaller ulcers healed more quickly than large ones, regardless of the drug used: 80 of 110 with diameter 3-5 mm (73%); 48 of 90 with diameter more than 8 mm (53%). Smoking delayed healing [healing rate among non-smokers, 87 of 117 (74%); among smokers, 113 of 189 (60%)]. Healing rates among smokers receiving omeprazole and non-smokers receiving ranitidine were nearly identical. After 4 weeks, at 96 and 92% respectively, there was no difference in regard to healing rate. Both drugs had a similar influence on the symptoms. Thus, for the first time it has been demonstrated that omeprazole is superior to ranitidine after 14-day treatment of duodenal ulcer.

Adolescent↗
PubMed1985

Monoclonal antibody defines CA 19-9 in pancreatic juices and sera.

In a retrospective study pancreatic juice samples (n = 213) and corresponding serum samples (n = 110) were assayed for their concentration of monoclonal antibody defined CA 19-9/GICA (gastrointestinal cancer associated antigen). Serum CA 19-9 values were found to be good diagnostic and discriminating markers for pancreatic disorders and were raised (greater than 50 u/ml) in more than 80% of the pancreatic cancer patients compared to 8.5% of the pancreatitis group and none of the control group. In contrast pancreatic juice CA 19-9 values showed a considerable overlap between groups. On the basis of recent molecular data on the monoclonal antibody 19-9 defined antigen(s)--that is, monosialoganglioside, mucin--it is proposed that the discrepancies between serum and pancreatic juice findings are due to a specific undirected endocrine release of the mucin into sera in pancreatic tumour patients while in pancreatic juices of all diagnostic groups high CA 19-9 activities are either owing to coexistence of glycolipid and mucin or that the latter is a physiologically exocrine product.

Antibodies, Monoclonal↗
PubMed1985

Diurnal rhythm of bile lipid composition after cholecystectomy and papillotomy. Postpapillotomy biliary lithogenicity.

The influence of the gallbladder and the sphincter of Oddi on the diurnal rhythm of bile lipid composition was assessed by determining the lithogenic index at 4-h intervals over a period of 24 h in 29 cholecystectomized and papillotomized patients with a nasobiliary tube receiving a normal hospital diet and in 9 during 1-day fast. With a normal diet, biliary cholesterol concentrations dropped during the daytime (p less than 0.05), and total biliary lipid, bile acid, phospholipid, and cholesterol concentrations rose at night (p less than 0.05). During fasting, total biliary lipid, phospholipid, and cholesterol concentrations rose continuously (p less than 0.01). Even with loss of function of the gallbladder and sphincter of Oddi, a diurnal rhythm of biliary lithogenicity persisted, caused mainly by cholesterol increases during fasting. Concomitant increases in phospholipids and, to a lesser extent, bile acids modulated these changes.

Aged↗
PubMed1985

Multiparametric tumor marker (CA 19-9, CEA, AFP, POA) analyses of pancreatic juices and sera in pancreatic diseases.

With respect to their diagnostic utility CA 19-9, CEA, AFP and POA were determined in pancreatic secretions and serum of patients suffering from pancreatic cancer (n = 76/55) or chronic pancreatitis (n = 79/45) and of controls (n = 81/42), respectively. While the determination of AFP and POA both in pancreatic secretions and serum does not permit a differential diagnosis, serum CEA (greater than 10 ng/ml) and CA 19-9 (greater than 50 U/ml) levels were indicative of pancreatic cancer in 30% and 83%, respectively, with a rate of false positive results of 5% and 8.5% confined to the chronic pancreatitis patients. A combination of tumor marker analyses, that is, serum CA 19-9 (greater than 50 U/ml) and pancreatic secretion CEA (greater than 70 ng/ml), proved to be positive in 92.9% of tumor patients with a maximum of 10.5% false positives. Likewise, values of serum CA 19-9 (greater than 50 U/ml) and serum CEA (greater than 10 ng/ml) were found in 85.8% of the pancreatic cancer patients with only 8.8% false positives, which were confined to the chronic pancreatitis patients. These results indicate the superiority of multiparametric tumor marker analyses for the diagnosis of pancreatic cancer, especially when including new monoclonal antibody defined tumor markers.

Antigens, Neoplasm↗
PubMed1985

Omeprazole heals duodenal, but not gastric ulcers more rapidly than ranitidine. Results of two German multicentre trials.

In two double-blind, randomized German multicentre trials the effects of omeprazole 20 mg mane and ranitidine 150 mg b.i.d. were compared for the first time in 334 outpatients with duodenal ulcer and 184 outpatients with gastric ulcer. In patients with duodenal ulcer endoscopically controlled healing rates after two weeks were 72% with omeprazole and 59% with ranitidine (p = 0.012); after 4 weeks 96 and 92%, resp. were healed (n.s.). In patients with gastric ulcer the healing rates after two, four, and eight weeks were 43, 81, and 95%, respectively, with omeprazole and 45, 80, and 90%, respectively, with ranitidine (n.s.). Smoking impaired healing in duodenal, but not in gastric ulcer. Symptom relief was comparable with both drugs. Serious side effects or clinically relevant changes in laboratory screening results were not detected. - Our results demonstrate for the first time that omeprazole 20 mg mane is superior to ranitidine 150 mg b.i.d. in the short-term treatment of duodenal, but not gastric ulcer.

Adolescent↗
PubMed1985

[Endoscopic balloon dilatation in stenosis of the pancreatic duct orifice (case report)].

We report the history and endoscopic treatment of a 63 year old female patient with chronic pancreatitis and stenosis of the pancreatic duct. Several operations of the biliary system had been performed in this patient previously (cholecystectomy 1964, choledochoduodenostomy 1972, revision of the choledochoduodenostomy 1974). In 1976 a chronic pancreatitis and a prepapillary stenosis of the Ductus wirsungianus has been diagnosed by clinical and endoscopic radiological findings. In order to relief pain we performed endoscopic sphincterotomies of the pancreatic duct orifice in 1976, 1977 and 1979. Because of relapsing abdominal pain and worsening of the pancreatic duct stenosis we performed two endoscopic balloon dilations of the proximal pancreatic duct at 20 months intervals. These lowered the pancreatoduodenal pressure difference from 40 mm Hg to normal values (below 13 mm Hg) over more than 12 months. Until today only few--less than ten--endoscopic dilations of the pancreatic duct orifice have been reported. A final estimation of this procedure is premature. However our case should stimulate other groups to consider this new form of therapy in selected patients with chronic pancreatitis and marked stenosis of the pancreatic duct.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1985

Ileal and colonic mucosal bile acids in Crohn's disease and right colonic carcinoma.

Bile acids are supposed to promote colonic cancer. In Crohn's disease, colonic carcinomas are relatively rare. We, therefore, compared ileal and right colonic mucosal bile acids analysed by gas-liquid chromatography in 8 patients with ileal Crohn's disease (14-48 yrs.) and 7 patients with right colonic carcinoma (28-77 yrs.) who underwent surgery. In both ileal and colonic mucosa, nonsulphated bile acid concentrations were somewhat higher in Crohn's disease (20.98 micrograms/g +/- 4.77 SEM; 12.09 micrograms/g +/- 2.55) than in colonic carcinoma (16.06 micrograms/g +/- 3.46; 7.75 micrograms/g +/- 4.28). In ileal mucosa, percentages of lithocholic and deoxycholic acids were slightly higher in colonic carcinoma (3.9%; 23.2%) than in Crohn's disease (1.1%; 14.9%). In colonic mucosa, carcinoma patients had more lithocholic (7.6%) and less deoxycholic acid (11.9%) than patients with Crohn's disease (1.7%; 20.3%). Bile acid sulphate esters were similar in both diseases (ca. 3.0 micrograms/g in ileal, 1.4 micrograms/g in colonic mucosa). Our results show that ileal and right colonic mucosal nonsulphated bile acids tend to be even lower in right colonic carcinoma than in Crohn's disease. This agrees well with our earlier findings of low mucosal bile acid concentrations in patients with left colonic carcinoma (Tokai J Exp Clin Med 8: 59-69, 1983) and does not support the assumption that bile acids are envolved in right colonic carcinogenesis.

Adolescent↗
PubMed1984

[Blood flow measurement in esophageal varices using an endoscopic Doppler ultrasonic probe].

A new ultrasound Doppler probe allows endoscopic measurement of blood flow in oesophageal varices. First investigations in 6 patients show that the measurements are easy and well reproducible. Velocity of blood flow depends on respiration. Cephalad flow increases during inspiration. Caudalad flow may be enhanced by expiration and decreased by inspiration. Cephalad and caudalad blood flow in the same varix may point to drainage by a perforating vein. During and after endoscopic sclerosing, changes in blood flow can be demonstrated. This method gives us the possibility to assess blood flow in oesophageal varices not only for pathophysiological studies, but also for planning and control of sclerosing therapy.

Blood Flow Velocity↗
PubMed1984

[Endoscopic intraductal radiotherapy of high bile-duct carcinoma].

A new method for palliative intraductal radiotherapy of high malignant bile duct occlusion was used in three patients. It consists of insertion of a 4 cm x 0,6 mm iridium-192 wire into the stenosis caused by the tumour. It uses a modified nasobiliary probe which is guided endoscopically retrograde transpapillary. A radiation output of 0.85 Gy/min (85 rd/min) and a requested therapeutic dosage of 60 Gy (6000 rd) at a distance of 0.5 cm lead to in situ position of the wire for about 70 hours. During that time bile flow is effected via the nasobiliary probe. The advantage over previously described methods (percutaneous transhepatic, surgical after installation of U-drainage) lies in a smaller complication rate and improved follow-up treatment as change of the endoprosthesis or repeat irradiation is not associated with renewed tissue trauma.

Adenocarcinoma↗