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Biomedical subjects

M Classen

Publications and source records attributed to M Classen.

At least 361 records · Page 20Linked to original sources
PubMed1983

[Endoscopic-sonographic diagnosis of the stomach wall].

Endoscopic ultrasonography makes it possible to measure and examine the wall of the upper gastrointestinal tract. It complements endoscopic visualization of the surface with analysis of the wall layers. Endoscopic ultrasound imaging reveals five different layers. Preliminary results indicate that benign gastric tumours can be distinguished from infiltrating gastric carcinoma. The extent and adjoining reaction of a gastric ulcer can also be visualized. Endoscopic ultrasonography of the stomach is a method of investigation that can be further developed and already shows considerable diagnostic potential.

Adenocarcinoma↗
PubMed1983

[Treatment of duodenal ulcer with synthetic depot secretin - a double-blind study].

63 inpatients with duodenal ulcer disease were treated with either depot-secretin or placebo. Two different secretin-regimens were used. In group I 18 patients were given secretin twice daily. 11 ulcers from a total of 19 ulcers healed within 3 weeks. In group II 23 patients were given secretin once daily. 21 out of 28 ulcers healed within 3 weeks. In the placebo-treated group 24 ulcers were observed in 22 patients. Of these 15 healed within 3 weeks. There was no statistical difference in the healing rate between the 3 groups. However, depot-secretin significantly improved typical symptoms. Analgetics were used less frequently. Serious side effects did not occur.

Adult↗
PubMed1983

Effect of sucralfate on peptic ulcer recurrence: a controlled double-blind multicenter study.

We entered 174 patients with healed duodenal ulcer and 77 with healed gastric ulcer into a double-blind, placebo-controlled, 6-month trial to investigate the efficacy of 1 g sucralfate twice daily in preventing ulcer recurrence. Endoscopy was performed after 6 months or earlier for symptoms compatible with ulcer disease. The relapse rate in the 126 patients with duodenal ulcer who could be evaluated for efficacy was 14/66 (21.2%) under sucralfate and 30/60 (50%) under placebo treatment (p less than 0.01). No significant difference in relapse rate was found in the 55 gastric ulcer patients who could be evaluated; 11 of 30 (37%) relapsed on sucralfate and 11 of 25 (44%) relapsed on placebo. Among the duodenal ulcer patients in the placebo group, those who had been treated initially with H2-receptor blockers for acute ulcer had significantly more relapses than patients who had been treated with other drugs. The recurrence rate was independent of prior treatment in the sucralfate group. Duodenal ulcer patients with a history of multiple episodes of active ulcer disease had a significantly higher rate of relapse than patients with only a few previous episodes. Both treatments were well tolerated. Two patients in each treatment group complained of nausea and epigastric pain immediately after drug intake. No other drug-related symptoms were observed. We conclude that sucralfate is effective in the prophylaxis of duodenal ulcer. No significant effect was found in the prevention of gastric ulcer recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

Aluminum↗
PubMed1983

[Hydrogen (H2) breath tests in the diagnosis of small intestine diseases].

We have applied the ion sensitive analysis of hydrogen (H2) in expired air in intervals of five minutes for five hours to determine carbohydrate malabsorption. In 19 patients with lactose malabsorption the increase in hydrogen was prior (45, SE 13 min) to healthy volunteers (142, SD 71 min, p less than 0.01). In comparison to blood glucose with the breath test no false positive results were observed. D-xylose absorption measured by breath test and renal excretion for five hours was determined in 24 volunteers and 12 patients with various intestinal diseases. There was a good correlation between both methods. In all patients the area under the concentration-time-curve was elevated (2077, SD 1260 ppm H2/5h) compared to healthy volunteers (434, SD 271 ppm H2/5h, p less than 0.01). Small bowel transit time was determined by ingestion of lactulose. In 32 healthy persons transit time was 85, SD 19 min. In 10 patients an early increase in hydrogen indicated bacterial overgrowth in the small bowel while 14C-Cholylglycine-breath test was abnormal in only six patients. The hydrogen breath test measured by ionsensitive mode is noninvasive, well tolerated, semiquantitative, and ideally suited for screening of intestinal disorders.

Adult↗
PubMed1983

Dacarbazine (DTIC)-induced human liver damage light and electron-microscopic findings.

The first electron-microscopic description of DTIC-induced human liver injury is presented. A 61-year-old man developed signs of hepatic failure during the second treatment cycle with DTIC for malignant melanoma. Light-microscopic examination revealed extensive centrilobular liver necrosis. Terminal hepatic venules did not show any signs of vasculitis or thrombosis and there was a lack of inflammatory infiltration. At the ultrastructural level intracytoplasmic, membrane-bound, organelle-free vacuoles were found in the hepatocytes. Liver cells showed bleb formation. Bile canaliculi were dilated and their microvilli flattened. In the pericanalicular exoplasm electron-dense fibrillary material, thought to be of microfilamentous origin, accumulated. The patient received 250 mg methylprednisolone i.v. at the very onset of symptoms and was discharged 12 days after the peak rise of transaminases with normal liver parameters.

Chemical and Drug Induced Liver Injury↗
PubMed1982

[Excretory pancreatic function: comparison of indirect function tests with the secretin-cholecystokinin test].

In 72 patients with chronic pancreatitis results of tbe secretin-cholecystokinin test were compared with those of several indirect test of pancreatic function (faecal fat content, chymotrypsin activity in faeces, peptide-PABA test, fluorescein-dilaurate test and weight of faeces). In 46 patients with markedly impaired pancreatic secretion the indirect tests were abnormal in 56-83% of cases. In 26 patients with normal or upper-limit-of-normal excretory function the same tests were abnormal in 15-77%. These results indicate that indirect tests of pancreatic function are of only limited value in the early diagnosis of pancreatic insufficiency.

Adult↗
PubMed1982

[Combined irrigation and endoscopy in the treatment of biliary duct stones (author's transl)].

In ten patients with biliary duct stones reoperation was not indicated and endoscopical stone extraction after papillotomy had failed due to the size of the concrements. As in some patients cholecystectomy had been performed several years ago and in others had not been done yet, treatment was commenced via an endoscopically inserted nasobiliary tube using media dissolving cholesterol and calcium bilirubinate stones. Results of treatment were satisfactory and side effects were tolerable. Results were compared with those after treatment with glycero-1-monooctanoate (Capmul 8210). In four patients distribution in the intra and extrahepatic biliary duct system was investigated by admixture of radiographically opaque media with both irrigation fluids. It was shown that both the oily and watery phase of the irrigation media were distributed homogeneously in the duct system and that the stone surface was covered adequately.

Aged↗
PubMed1982

[Clinical features of inflammatory bowel disease (author's transl)].

Inflammatory bowel disease may be caused by virus, bacteria, fungus, parasites or mechanical conditions. Among the inflammatory bowel diseases caused by bacteria salmonellosis and cholera are most important. Their treatment has been revolutionized within the last decade. Instead of the administration of antibiotics the usage of fluids, glucose and electrolytes represents the method of choice. Using the so called "traveller's disease" as an example the pathophysiological aspects of the treatment may be best explained. Etiology and pathogenesis of Crohn's disease, the incidence of which seems to be increasing lately, are still unknown. Before onset of treatment it is essential to establish an exact diagnosis, further to determine distribution and inflammatory activity, as those control the therapy. Salazosulphapyridine and steroids have proved effective drugs. Azathioprine should only be used combined with steroids. Recent investigations suggest that certain formula diets, such as e. g. Survimed, may be useful in the management of the disease as well.

Azathioprine↗
PubMed1982

[Zollinger-Ellison syndrome--changes in surgical therapy. Analysis of 27 patients].

In 10 out of 27 patients with a Zollinger-Ellison syndrome a gastrin-producing tumor was removed, in 5 localized with phlebography. In the remaining 12 patients the diagnosis of a gastrinoma was based on clinical data only. The 10 patients with surgically proven gastrinoma did not differ in their fasting blood-glucose levels, rise of gastrin serum levels after administration of secretin and calcium, in acid production patterns nor in survival time from those 12 patients in whom no gastric-producing tumor had been found. 5 of the 27 patients died, 4 just after surgery. One patient died from advanced malignant disease. In three of our patients localizing diagnostic procedures and consecutive tumor-removal were feasible with the protection of H2-receptor antagonists. The trend in the treatment of ZES goes away from elective total gastrectomy towards conservative treatment with H2-receptor antagonists in view of the low morbidity and the attempt of curative treatment by tumor-removal.

Adult↗
PubMed1981

[Endoscopic determination of the size of gastrointestinal ulcers (author's transl)].

A new method based on computer-assisted semi-automatic equipment for stereological analysis has been developed to measure ulcer size endoscopically. The main component is a graphic measuring table connected with a computer which is itself linked to a television monitor. The endoscopic picture is transmitted to the television monitor and the ulcer area is measured directly on the monitor using electronic overlay markers. The trace of the measuring markers remains visible on the monitor so that every lesion demonstrated is accurately outlined. The computer calculates the ulcer area by relating it to a known endoscopically inserted reference area. Numerous measurements from various distances, various angles of view and with variable reference area sizes showed the error to be 4.2 +/- 0.5%. Measurements by six different investigators showed variations of 2.9 +/- 1.2%. These results document the reliability of endoscopic planimetrics of gastrointestinal ulcers.

Anthropometry↗