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Biomedical subjects

M Classen

Publications and source records attributed to M Classen.

At least 379 records · Page 21Linked to original sources
PubMed1981

[Endoscopy of esophageal cancer (author's transl)].

The late stages of symptomatic esophageal carcinoma rarely present diagnostic difficulties. Nevertheless, the tumor must be bioptically analyzed and defined to decide on proper treatment. Our future aim is to diagnose esophageal carcinoma at an early stage. Dysphagia should increasingly be accepted as an indication for endoscopy. Biopsy should be accompanied by cytology and vital staining. Regular controls in risk groups should help to improve the poor prognosis of esophageal carcinoma in our country.

Biopsy↗
PubMed1981

Endoscopic approach to papillary stenosis (PS).

Gastrointestinal endoscopy includes important possibilities for the diagnosis and therapy of papillary stenosis (PS). The surface of the papilla of Vater and the ampulla and the terminal common bile duct after EPT can be visualized directly. By means of ERCP the structure of the ampulla, the pancreatic duct and the biliary duct can be demonstrated. The motor activity of the sphincter of Oddi and the drainage time provide valuable information applicable to the diagnosis of PS. Histological examinations of snare and forceps biopsies are of the utmost importance for the differential diagnosis of benign and malignant PS. The advent of endoscopic papillotomy made benign PS an "endoscopic disease". In patients with benign circumscribed PS, surgical sphincterotomy is only rarely indicated. The high success rate of endoscopic papillotomy in PS makes biliary drainage by the transduodenal or the percutaneous transhepatic route superfluous in the majority of cases. We do not regard laser coagulation of papillary cancer as the treatment of choice although it may be indicated in patients who are inoperable or who refuse surgery. - Today, gastrointestinal endoscopy offers the decisive diagnostic and therapeutic approach to papillary stenosis.

Ampulla of Vater↗
PubMed1981

A new method for the endoscopic determination of gastrointestinal ulcer area.

Current endoscopic measurements of gastrointestinal ulcer area using forceps or graduated probes are associated with a high degree of inaccuracy. Based on a computer-assisted, semiautomatic device for stereological analyses, we have developed a new method for the endoscopic determination of ulcer size. The basic elements are a graphical measuring tablet coupled with a computer, the later being connected to TV-monitor. The endoscopic picture is transmitted to the TV-monitor and the ulcerated area is measured directly on the TV-monitor by means of an electronic overlay marker. The trace of the marker remains visible on the screen so that any circumscribed lesion can be labelled exactly. From the relation of a known, endoscopically introduced reference area to the circumscribed ulcerated area, the latter is calculated by the computer. Multiple measurements obtained at different distances, and visual angles, and with different reference areas, revealed an error of 4.2 +/- 0.5%. Inter-observer variation among 6 different examiners was 2.9 +/- 1.2%. These results document the reliability of endoscopic planimetry of gastrointestinal ulcers.

Computers↗
PubMed1981

Pancreatic oncofetal antigen in pancreatic juices. Partial chemical characterization and diagnostic application of a pancreatic cancer-associated antigen.

Antisera were raised in rabbits to an antigenic structure present in fetal pancreas tissue, pancreatic tumor tissue, and pancreatic juices and in sera obtained from pancreatic cancer patients. The first chemical data indicate that this pancreatic oncofetal antigen is distinct from CEA, NCA, and NCA2 and is not glycolipid in nature. Immunoelectrophoretic analyses demonstrate that pancreatic oncofetal antigen is a protein or a glycoprotein, which displays microheterogeneity. The apparent molecular weight of the basic unit of pancreatic oncofetal antigen is estimated to about 40 K. So far 234 pancreatic juices have been investigated for pancreatic oncofetal antigen. Pancreatic oncofetal antigen was detected within the pancreatic juices from 59 of 74 (80%) pancreatic carcinoma patients but could be traced in only 16%-26% of samples obtained from patients with other diseases.

Adult↗
PubMed1981

Alternating treatment of common bile duct stones with a modified glyceryl-1-monooctanoate preparation and a bile acid-EDTA solution by nasobiliary tube.

Twenty patients with bile duct stones were treated via an indwelling nasobiliary tube with a modified Capmul 8210 preparation (GMOC) and alternating with a bile salt-EDTA (BA-EDTA) solution for an average of 12 days. In vitro the dissolution capacity of GMOC and BA-EDTA for cholesterol stones was higher than that of Capmul 8210. The nasobiliary tube was tolerated well for a maximum of 84 days; this renders us independent of the T-tube. The therapeutic success rate of GMOC was 64%, even though we treated mostly old and large concrements. Side effects occurred markedly less than with Capmul 8210. In patients with acute cholecystitis or cholangitis the clinical course improved under therapy, and there was no deterioration of a chronic condition.

Aged↗
PubMed1981

Diagnosis of pancreatic cancer by pancreatic oncofetal antigen (poa) in pure pancreatic juice.

Pancreatic oncofetal antigen (POA) was detected in the pure pancreatic juice by double immunodiffusion assay in a series of patients, using anti-POA prepared by immunizing rabbits with human fetal pancreas homogenate. The test was positive in as many as 72% of the patients with pancreatic cancer studied, whereas only less than 10% of patients with other diseases or normal controls were positive for this antigen, thus suggesting a potential usefulness of the pure pancreatic juice assay for POA in the diagnosis of cancer of the pancreas. The POA has proven to be distinct from such oncofetal antigens as AFP and CEA, to be labile to heating at 85 degrees C, to show beta-mobility on immunoelectrophoresis and to have a molecular weight of approximately 37,000 as estimated by gel filtration chromatography.

Adult↗
PubMed1980

Descending sphincterotomy of the papilla of Vater through a choledochoduodenostomy under endoscopic view. Another variant of endoscopic papillotomy (EPT).

Endoscopic papillotomy required deep cannulation of the papilla of Vater. But retrograde placing of the papillotome in the distal common bile duct is not always possible. Occasionally conditions permitting a descending antegrade cannilation of the papilla are found. An existing choledochoduodenostomy can be used as access for such a cannulation from above. A papillotome, type Erlangen, introduced into the papilla from above, spontaneously adopts the correct cutting direction. With regard to its length the incision has, however, to be monitored endoscopically. Also, undesired additional burns in the duodenum only can be avoided by endoscopic control. This may require the use of a second instrument. The technique described above was successfully applied as another variant of descending papillotomy.

Aged↗
PubMed1980

Experiences with the long standing nasobiliary tube in biliary diseases.

Specially designed longstanding nasobiliary tubes allow to reflect upon some well established therapeutic rules. The safe, decompressing effect of the tube leads to prompt relief of obstructive suppurative cholangitis. Therefore emergency of laparotomy can be avoided in high risk patients. Large common bile duct stones until now have required a large papillotomy with increased frequency of complications. The attempt to dissolve those stones with Capmul is justified on an account of a 50% success rate. Either a very small EPT or even non is necessary in order to insert the tube.

Acute Disease↗
PubMed1980

Ultrasonic tomography by means of an ultrasonic fiberendoscope.

The diagnositc value of ultrasonic tomography of the upper abdominal organs is sometimes limited by bones and gas. Endoscopic ultrasonography (EUST) combines the advantages of the direct visualization of the upper GI tube and the ultrasonic imaging of adjacent organs. The ultrasonic probe consists of a 5 MHz array that generates a good resolution at the acustical focus, the endoscope is a conventional Olympus gastroscope type GFB3. The ultrasonic transducer is firmly attached to the distal end of the endoscope. Combined examinations are performed in 18 patients with biliary, pancreatic and hepatic disorders or postoperative changes. EUST may be of value not only for gastrointestinal but also for retroperitoneal, cardiac, and mediastinal diseases.

Adult↗
PubMed1980

[Longterm controls after endoscopic papillotomy [EPT] (author's transl)].

In 117 patients who have undergone endoscopic papillotomy (EPT) long term controls have been done. 51 were controlled in the hospital and 66 did answer a questionnaire. The mean time interval to the EPT was mean = 21.6 months. Nine out of every ten patients had no complaints. One third had minimal changes of laboratory dates, which can easily be explained by second diseases. With nearly no exception there was a large orifice to the common bile duct at the upper brim of the papilla. There was no bilioduodenal pressure gradient in 75%. Duodenobiliary reflux could be demonstrated in 25% and aerobilia in 65%. Although there was a massive bacteriobilia in all cases, no signs of cholangitis could be found in any patient. As a result, no unfavourable effects of the EPT became obvious during this follow-up study.

Aged↗
PubMed1979

Enteropancreatic circulation of trypsin in man.

Following the intraduodenal installation of purified 125I-labeled human trypsin up to about 4--6% of the label was measured after 15--30 min in blood plasma and found to separate in a dextran-gel filtration system similar to purified human trypsin (-125I) after incubation with human serum. About 1% of the installed trypsin-(-125I)-dose was found already after 20 min in 100 ml of aspirated pancreatic secretion and later on also in the duodenal content. The results support the concept of the existence of an enteropancreatic circulation of trypsin also in man and explain in part the low to non-detectable levels of immunoreactive serum trypsin observed in patients with exocrine pancreatic insufficiency.

Humans↗
PubMed1979

[Proctitis].

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Humans↗