PubMed Health⌕ Search

Biomedical subjects

M Gebel

Publications and source records attributed to M Gebel.

90 records · Page 5Linked to original sources
PubMed1985

[Width of the lumen of the common bile duct: sonography compared with ERCP].

The diameter of the common bile duct can be easily determined by ultrasound and by ERCP (endoscopic retrograde cholangiography). The measured values differ by as much as 20% due to the technical features of both methods. A study with 100 patients showed that in 20% of the patients the diameter of the common bile duct determined by ERCP was twice that of the value determined by sonography. The difference can be definitely explained by the influence of butyl scopolamine and the high-pressure injection of the contrast medium into the bile duct system. The sonographic measured size of the common bile duct is correlated with the physiological value but a sure prediction of the expected value to be determined by ERCP is not possible.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1984

Sonographic pattern of focal nodular hyperplasia of the liver.

Focal nodular hyperplasia of the liver (FNH) is a histologically defined benign hepatic tumour, possibly associated with the use of oral contraceptives. The present study deals with the question whether FNH can be distinguished from other lesions of the liver by ultrasonography alone or by a combination of real-time sonography and radiologic procedures. Therefore 18 cases of FNH, 16 females and 2 males, are presented. We retrospectively reviewed the diagnostic results of real-time sonography, hepatic scintigraphy, computed tomography with dynamic CT-densitometry, and angiography on these 18 patients. Ultrasonography enables the identification of the lesion in all of the 18 cases. FNH appears to show varying degrees of echogenicity (slight hypoechoic in 6 cases, isoechoic in 6 cases, and slight hyperechoic in 4 cases). In most of the patients the tumour had similar acoustic characteristics as the surrounding normal liver. By ultrasonography alone there is no possible differentiation of FNH from other hepatic tumours. Both the echo pattern of FNH and the results of the ultrasonically guided cytopuncture are unspecific.

Adolescent↗
PubMed1980

[Ultrasound in the diagnosis of ileitis terminalis Crohn (author's transl)].

In order to check the value of sonography in the diagnosis of Crohn's disease, 81 patients who suffered from Crohn's disease were examined by means of real-time B-mode ultrasound. Bowel wall infiltration along the terminal ileum that could be shown to involve the coecum as well, appeared to be a reliable parameter in the diagnosis of Crohn's disease. This finding was most pronounced in acute disease whereas in chronic or mild disease, characteristic signs of Crohn's disease were absent. Among the complications of Crohn's disease formation of intraabdominal abscesses can be demonstrated by sonography. From our results we propose to employ diagnostic ultrasound in the acute stage of disease. After remission the diagnosis should be confirmed by endoscopy and X-ray examinations.

Abscess↗
PubMed1980

[Radiological findings in renal capsular tumors (author's transl)].

Renal capsular tumors are rare. Preoperative diagnostic is based on radiology. Typical urographical findings are marginal impression and dislocation of the entire kidney without deformation of renal pelvis and calices. Angiography is the most decisive method of investigation, especially in malignant mass lesions. These tumors generally have hypovascular neovascularity without puddling. They can be supplied both by capsular and renal, lumbar and intercostal arteries. The renal parenchyma is contrasted homogeneously without defects, the margin is sharply defined. Computer tomography can best demonstrate the extent of the lesion and distinguish it from neighboring organs; in lipomas and cysts even a histological prediction is justified with this method. Preoperative diagnostic accuracy is limited by the fact, that even the pathologist, in some cases, is not able to decide upon the origin of these tumors.

Adult↗
PubMed1979

[Computerized tomographic localization of insulinomas (author's transl)].

Computerized tomographic localization of insulinomas utilises the differences in radiodensity between the tumor and the adjacent pancreatic tissue. With the aid of this new technique four insulinomas have been localized preoperatively. All of the tumors had the same radiodensity. Firm, well encapsulated beta-islet-cell tumors were detected with the same ease as an insulinoma, which was soft and almost without encapsulation. The smallest tumor detected was 1.0 cm in diameter. Of the four insulinomas, localized by computer tomography of the body, only one was also detected angiographically and only two were detected sonographically.

Adenoma, Islet Cell↗
PubMed1979

Follow-up study of chronic gastric erosions.

Chronic gastric erosions were detected with a frequency of 4.4% in 8,468 patients over the six year period from 1971 to 1977. The lesions were usually multiple, chain-like or clustered, along the greater curvature. The age group most often afflicted was the 50-60 year olds, and male predominance were three to one. In one-third of the cases, chronic erosions were found in combination with gastric or duodenal ulceration. Longterm observation of 64 patients over a period of four and a half years revealed no change in the condition in 50%, increase, decrease or complete disappearance of the lesions were found in the remaining 50%. In 10% chain-like multiple erosions developed into a persisting fold in the gastric mucosa. No evidence suggesting that erosive lesions lead to chronic ulceration or development of either polyps or malignancy within 4 1/2 years was recorded, nor was there any association with gastric protein loss.

Adolescent↗
PubMed1979

[Diagnostic criteria for pancreatic sonography during the course of uncomplicated acute pancreatitis (author's transl)].

The course of uncomplicated pancreatitis was followed by sonography in 45 patients. The changes during the disease and their temporal relationship to the clinical stage are illustrated by an example. During the initial phase of the disease the sonographic findings may be so slight that they are easily missed, although clinical symptoms are present. It is only during the main phase of the disease that the typical sonographic findings of acute pancreatitis develop. At this time, maximal increase in amylase activity has usually passed. During recovery, with uninterrupted clinical and biochemical improvement, changes in the sonogram can still be seen for between three weeks and four months.

Acute Disease↗
PubMed1979

[Endoscopic retrograde cholangiopancreaticography (ERCP) and percutaneous transhepatic cholangiography (PTC) in cholestatic syndromes of children and adolescents (author's transl)].

Conventional cholangiography had failed to establish a diagnosis in 5 children aged 6 weeks to 14 years and in 6 adolescents aged 14 to 18 years suffering from cholestasis; therefore endoscopic retrograde cholangiopancreaticography (ERCP) was performed, allowing to establish congenital biliary tract anomalies, cholelithiasis and benign obstruction of the extrahepatic biliary tract as causes of the cholestatic syndromes. Thus ERCP again turned out to be a valuable diagnostic procedure. Percutaneous transhepatic cholangiography (PTC) using the Chiba technique has not yet been applied in infancy to a great extent. Application of PTC however should be considered as well in cholestasis. It cannot yet be decided, if ERCP or PTC is to be prefered in neonatal cholestasis; further investigations are needed to clear up this point.

Adolescent↗
PubMed1978

[False diagnosis of phlebothrombosis (author's transl)].

Clinical signs of deep vein thrombosis of the calf in diseases of the knee joint may lead to a false diagnosis. Two examples illustrate how bursae or herniated cysts at the back of the knee may resemble acute phlobothrombosis when they increase in size or rupture. Sonographic investigations are the method of choice for diagnosis and differentiation of cysts as well as for the follow-up.

Adult↗
PubMed1978

[Results of treating the acute stage of Crohn's disease by a dietary regimen (author's transl)].

23 consecutive patients (13 women, 10 men; mean age 31 years) with acute exacerbation of Crohn's disease were treated by a dietary regimen based on "resting" the bowel by parenteral nutrition or a balanced synthetic diet (Vivasorb), followed by stepwide introduction of a low-residue diet. Cardinal symptoms such as severe abdominal pain, diarrhoea, incomplete ileus or weight loss responded favourably to treatment in each case. Postoperative fistulae closed in two of three patients. Enterocutaneous fistulae, however, remained open in all five patients, although the volume of secretion decreased distinctly in four. During the follow-up period (averaging nine months after discharge from hospital) symptoms recurred in five patients, necessitating operative treatment in three.

Acute Disease↗
PubMedDate not supplied

[Therapy of Helicobacter pylori infection: current status].

H. pylori is closely associated with gastritis, peptic ulcer disease and gastric cancer. A causative role of H. pylori is now established in type B gastritis, its role in non ulcer dyspepsia is unresolved. Eradication of H. pylori results in a marked decrease of peptic ulcer relapse rates. Gastric cancer risk is 2- to 8-fold increased if gastric mucosa is colonized by H. pylori. Treatment of H. pylori infection is difficult although the organism is highly sensitive to several antibiotics in vitro. Monotherapy with bismuth suppresses bacterial growth, but hardly ever eradicates the organism. Combination of amoxicillin with omeprazole may eradicate H. pylori in about 60-80% of patients and is well tolerated. Triple therapy (bismuth, amoxicillin, metronidazole) is the most effective treatment modality and results in eradication rates of 80% to 90%, however, side effects are noticed in 20%-30% of patients. Eradication of H. pylori should be considered under the following conditions: relapsing peptic ulcer, resistant peptic ulcer, break-through ulcer on maintenance treatment with H2-blockers, complicated ulcer. There is no indication for eradicating treatment in patients with simple H. pylori positive gastritis and NSAID-associated ulcer.

Anti-Bacterial Agents↗
PubMedDate not supplied

Perihepatic lymphadenopathy: a marker of response to interferon alpha in chronic hepatitis C.

BACKGROUND/AIMS: Recently it was shown that perihepatic lymphadenopathy (PHL) correlates with histological activity in chronic hepatitis C. However, the question whether there is a correlation between the response to interferon alpha and PHL has not yet been raised. METHODOLOGY: We examined 103 patients who had been treated with interferon alpha for hepatitis C. Prior to treatment all patients had undergone high resolution ultrasonography. Thirty-six patients had follow up ultrasound scans during the course of the treatment. According to size and number of lymph nodes we introduced a grading of the PHL and determined grade I as minimal, grade II as medium and grade III as extensive PHL. RESULTS: Classification of PHL prior to treatment revealed 40 patients with PHL I, 30 with grade II and 33 with grade III. Hepatic inflammatory activity according to the Ishak score was increased in patients with PHL III (9.1+/-2.4) compared to PHL II (6.7+/-2.9) and PHL I (7.3+/-3.1) (p=0.01). In patients with PHL grade I prior to treatment 45% were initial responder, patients with grade II or III showed response rates of 40% and 33%, respectively. During therapy we found an increase of PHL in one out of 13 primary responder vs. 10 out of 23 non-responder (p=0.03). CONCLUSIONS: In conclusion, monitoring of PHL by abdominal ultrasonography is a simple, non-invasive and cheap additional marker of response to interferon alpha.

Adolescent↗