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Biomedical subjects

M Wegener

Publications and source records attributed to M Wegener.

At least 37 records · Page 2Linked to original sources
PubMed1998

Outcome of 1000 consecutive clinic- and hospital-based cataract surgeries in a Danish county.

PURPOSE: To evaluate the homogeneity and quality of cataract surgery in a Danish county. SETTING: Four private eye clinics and the Department of Ophthalmology, Hillerød Hospital, Frederiksborg County, Denmark. METHODS: This prospective study comprised 1012 consecutive cases of age-related cataract; 48% of the surgeries were performed in the hospital and 52%, at 1 of 4 clinics. Demographic and clinical data were recorded on standardized data sheets at referral, surgery, and final refraction. Main outcome measures were change in best corrected visual acuity (BCVA), refractive power at final refraction, surgery-related complications, and waiting time for surgery and final refraction. RESULTS: The hospital group had greater dispersion of age (P < .001) and higher frequency of general health problems (P < .005) and glaucoma (P < .01) than the clinic group. Fifty-four percent of surgeries were by phacoemulsification and 46%, by extracapsular cataract extraction (ECCE). In general, phacoemulsification was prevalent at the hospital and ECCE at the clinics. No difference was found between groups in visual acuity at final refraction. Of all patients, 87.1% attained a BCVA of 0.5 or better and of the best cases, 96.2%. Zonule or capsule rupture with or without vitreous loss occurred more often in the hospital group (P < .05), while the incidence of postoperative complications was identical in the 2 groups. One cases of retinal detachment was found. Time from referral to final refraction was shorter at clinics, while waiting time from surgery to final refraction was shorter at the hospital (P < .001). CONCLUSION: Dividing cataract surgery between hospital and private clinics seems to be a satisfactory model for meeting the increasing demand for cataract surgery.

Adult↗
PubMed1997

Structure of stratum corneum lipids characterized by FT-Raman spectroscopy and DSC. II. Mixtures of ceramides and saturated fatty acids.

Fourier transform (FT) Raman spectroscopy and differential scanning calorimetry (DSC) were used to study the thermotropic phase behaviour of mixtures of ceramides type IV (CER) and stearic acid (SA). For comparison the melting behaviour of SA was re-examined. The Raman spectra of all mixtures in the solid state show sharp bands associated with trans sequencies of the alkyl chain residues of both lipids. These features demonstrate that the hydrocarbon chains are highly ordered in the mixtures, too. The temperature dependence of the conformationally sensitive bands is used to estimate the degree of order in terms of the relative population of trans and gauche conformations. The DSC heating curves for the mixtures show two endothermic transitions which are typical for eutectic melting. The factor group splitting of the CH2 scissoring mode, arising from the orthorhombic subcell packing of SA, disappears in the course of the eutectic melting of samples with a SA content lower than 90 mol%. Both DSC and Raman spectroscopic studies reveal that CER and SA are immiscible in the solid state. The phase diagram of the system is a simple eutectic type one. The addition of SA to CER shifts the melting temperature of ceramides to lower values. However, though SA is a major component of stratum corneum (SC) it is not efficient enough to increase the fluidity of ceramides.

Calorimetry, Differential Scanning↗
PubMed1997

Structure of stratum corneum lipids characterized by FT-Raman spectroscopy and DSC. III. Mixtures of ceramides and cholesterol.

The thermotropic and lyotropic phase behaviour of mixtures of ceramides type IV and cholesterol was investigated using Fourier transform (FT) Raman spectroscopy and differential scanning calorimetry (DSC). In the dry and in the fully hydrated state of these mixtures the DSC-curves exhibit an eutectic melting followed by the melting of the residual solid component. The Raman spectrum of the mixtures is complex, nevertheless, the appearance of the conformationally dependent bands indicates the ordered structure of the hydrocarbon chains. The temperature dependence of the conformationally sensitive bands in the CH2 stretching region (2800-2975 cm-1) and in the chain C-C stretching region (1050-1150 cm-1) was used to estimate the degree of order in terms of the relative population of trans and gauche conformers. The spectrum of the pure cholesterol shows only a weak temperature dependence in the CH2 stretching region and, therefore, the decrease of the intensity of the asymmetric CH2 stretching mode at 2880 cm-1 can be attributed to the melting of the alkyl chains of ceramides. The temperature and width of the phase transition, derived from Raman data, are similar to those of the DSC study.

Calorimetry, Differential Scanning↗
PubMed1997

Gastric dysrhythmias and delayed gastric emptying in patients with functional dyspepsia.

An association between dyspepsia, gastric motility disorders, and myoelectrical abnormalities has been noted. The objective of the present study was to investigate both antral myoelectrical activity and gastric emptying in patients with functional dyspepsia (FD). Electrogastrography (EGG) was performed in 25 adult patients with FD, which had been evaluated by score. After an overnight fast, for 1 hr in the pre- and postprandial state (370 kcal liquid-solid test meal) the following EGG parameters were determined: dominant frequency [DF (cpm)], DF (%) in the normal range (2-4 cpm), bradygastria (<2 cpm), tachygastria (4-10 cpm), dominant frequency instability coefficient (DFIC), and postprandial to fasting power ratio (PR). The data were correlated to results obtained in 20 age- and gender-matched controls. In addition, in 17 consecutive patients the EGG data were compared to the gastric retention of radionuclides after 60 min (liquid-solid phase labeled with 99mTc colloid). Patients with FD revealed a preprandial increase in tachygastria compared to controls (P < 0.001). Of 17 FD, seven patients exhibited delayed gastric emptying (t60 retention >68%). These patients showed significantly more pre- and postprandial tachygastrias than patients with normal gastric emptying (P < 0.05). The dyspeptic symptomatology and H. pylori status did not correlate with EGG and radioscintigraphy. Patients with FD frequently reveal impaired gastric emptying and increased tachygastria, which may have pathophysiological significance in some of these patients.

Adult↗
PubMed1996

[The effect of lumbar relief orthoses with abdominal compression on esophago-gastrointestinal motility].

OBJECTIVE: To investigate the effect of lumbar ortheses with abdominal compression on gastro-oesophageal reflux and gastrointestinal transit. PATIENTS AND METHODS: In a prospective study 20 consecutive patients with lumbar syndrome treated with lumbar orthesis (10 female, 10 male, median age 54.6 years) were investigated for gastro-oesophageal reflux, mouth-to-cecum transit time (MCT), and whole-gut transit time. Gastro-oesophageal reflux was assessed performing an ambulatory pH metering of the distal oesophagus over a period of 10 h with and without ortheses on two separate study days. After positioning of the pH catheter patients ingested a liquid-solid test meal labelled with 10 g lactulose and 750 g indigocarmine to determine MCT with the hydrogen breath test and whole-gut transit by the first appearance of indigocarmine in the stool. Dyspepsia was assessed by using a standardized questionnaire. RESULTS: Lumbar ortheses induced a significant increase in reflux time (pH < 4) (8.1 vs 4.1%), total number of reflux episodes (102.5 vs 69.5) and duration of longest reflux episode (6.0 vs 3.7 min) (P < 0.05). 12 patients with ortheses revealed an increase in relative reflux time (2.1-24.5%, median: 8.2%) more than two standard deviations compared to previously obtained normal values. In these patients during ortheses dyspeptic symptoms correlated significantly with reflux time (r = 0.6; P < 0.05). In contrast, MCT and whole-gut transit time in patients with and without ortheses did not differ significantly (85 vs 85 min; 10.2 vs 9.6 h). CONCLUSION: Lumbar ortheses with abdominal compression, nowadays frequently used in the lumbar syndrome, produce gastro-oesophageal reflux associated with dyspepsia. Gastrointestinal transit time is not affected, though.

Adult↗
PubMed1996

[The 13C-acetate breath test for the noninvasive assessment of the gastric emptying of a liquid/solid test meal in diabetics].

OBJECTIVE: To test in a prospective study whether the non-invasive 13C-acetate test is suitable for measuring gastric emptying time with a liquid/solid test meal. (99m)technetium scintigraphy served as the reference method. PATIENTS AND METHODS: 18 consecutive type 2 diabetics with symptoms of gastroparesis (nine men, nine women; mean age 64 [45-76] years) were, after a nocturnal fasting period, given a liquid/solid test meal (370 kcal; 100 ml coffee; doubly marked with 75 mg 13C-acetate and 0.5 mCi 99mTc-colloid). At ten-minute intervals breath samples were taken over two hours and examined by mass spectometry for the 13CO2/12CO2 ratio. In parallel scintigraphy was performed for one hour at one-minute intervals. Gastric emptying half-life (t1/2) was calculated and the correlation between the two methods determined. In addition, the 13C-acetate breath test was performed on 20 healthy subjects to assess reproducibility (ten men, ten women; mean age 44.4 [23-77] years). RESULTS: Median t1/2 with the scintigraphy was 93.5 min, with the breath test 55 min, i.e. a significant correlation (r = 0.8; P < 0.001). Four of five patients with delayed gastric emptying by scintigraphy also showed delay (compared with the control group) in the breath test (median t1/2: 41 min; 95th percentile: 86 min). CONCLUSION: The 13C-acetate test correlated significantly with the results by scintigraphy. It can therefore be recommended as a non-invasive test for assessing gastric emptying time after a liquid/solid test meal in type 2 diabetics.

Acetates↗
PubMed1996

Cure of Helicobacter pylori infection: role of duration of treatment with omeprazole and amoxicillin.

OBJECTIVES: To date, some studies have suggested that short-term therapy may be a promising therapeutic concept for the eradication of Helicobacter pylori. The primary objective of the present study was to elucidate the role of the duration of treatment in the cure of H. pylori infection. METHODS: Forty consecutive patients with H. pylori-positive peptic ulcer disease were randomly allocated to four study groups. The groups were treated with a 14-day course of 20 mg omeprazole b.i.d. orally combined with 2 g amoxicillin t.i.d. intravenously for 1 day (n = 10; six women, age range 40-84 yr), for 3 days (n = 10; five women, age range 29-74 yr), for 5 days (n = 10; five women, age range 21-82 yr), for 7 days (n = 10); five women, age 42-82 yr), respectively. Initially, a standardized clinical evaluation of symptoms and and upper GI tract endoscopy were performed for assessment of H. pylori infection of the gastric mucosa (biopsy urease test, specific culture, and histology). At least 4 wk after cessation of omeprazole medication, H. pylori eradication was evaluated either as described or with the help of the 13C-urea breath test. RESULTS: H. pylori eradication, defined as negative bacterial findings in urease test, culture, and histology or 13C-urea breath test at least 4 wk after discontinuation of omeprazole therapy, was achieved in one of 10 patients (10%) in the one-day group, none of 10 patients (0%) in the 3- and 5-day groups and six of 10 patients (60%) in the 7-day group. CONCLUSION: We conclude that short-term therapies with the proton pump inhibitor omeprazole and the antibiotic amoxicillin must be considered completely ineffective if performed as a short-term therapy for up to 5 days. A therapy duration of 7 days seems to mark a turning point in antibiotic effectiveness, with a rapid increase in eradication rates.

Adult↗
PubMed1996

[Does chronic alcohol drinking modify digestive gastrobiliary motility?].

In 23 chronic alcoholics and 23 controls gastric emptying, antral motility, fasting gallbladder volume and gallbladder emptying after a standardized, liquid fatty meal were investigated ultrasonically in order to assess the effect of chronic alcoholism on postprandial gastrobiliary motility. Only a subgroup of the alcoholics with signs of autonomic cardiovascular neuropathy (21.7%) exhibited a significant antral hypomotility and a tendency towards higher fasting gallbladder volumes. No significant differences between the study groups could be obtained for the other parameters. The duration and daily amounts of alcohol consumption were not significant different between patients with autonomic neuropathy and patients without autonomic neuropathy. Within the whole group of alcohol consumers the only significant correlation that was observed occurred between the fat induced gallbladder residual volumes and the amounts of daily alcohol consumption (r = 0.62, p < 0.05). However 19 of these 23 relative gallbladder residual volumes were within the normal range (95. percentile of the control group), indicating no major clinical relevance of this phenomenon. None of the motility parameters exhibited a significant correlation to the duration of alcohol consumption. From these results chronic alcohol consumption has no irreversible effects of clinical relevance on the postprandial gastrobiliary motility in the majority of patients in contrast to well documented reversible effects of acute alcohol consumption on gastric motility.

Adult↗
PubMed1996

Endoscopic band ligation for treatment of post-polypectomy bleeding.

Endoscopic band ligation is a newly developed technique that has been proved to be an effective treatment of bleeding esophageal varices. Meanwhile, this technique also has been shown to be a successful method of controlling non-variceal upper gastrointestinal hemorrhage. Moreover, there are scattered reports about endoscopic band ligation for treatment of post-polypectomy hemorrhage. In this report, we describe the successful application of colonoscopic band ligation to control severe post-polypectomy colonic bleeding not responding to standard techniques.

Adenomatous Polyps↗
PubMed1996

Effect of progressive systemic sclerosis on antral myoelectrical activity and gastric emptying.

In patients with progressive systemic sclerosis (PSS) suffering from chronic dyspepsia the stomach may be affected by this disease. The objective of this study was to investigate both antral myoelectrical activity and gastric emptying in PSS patients. Electrogastrography (EGG) was performed in 17 PSS patients (16 female, one male, median age 58 years, range 32-74 years) with chronic dyspepsia. After an overnight fast during one hour in the fasting and one hour in the fed state after ingestion of a liquid-solid test meal (370 kcal; liquid phase labeled with 0.5 mCi 99mTc-colloid) antral electrical activity was measured by one pair of electrodes sonographically placed on the skin overlying the gastric antrum. Several EGG parameters including dominant frequency (DF), percentages of DF in the normal range (2-4 cycles per minute [cpm]), bradygastria (< 2 cpm) and tachygastria (4-10 cpm), dominant frequency instability coefficient (DFIC), and postprandial to preprandial power ratio (PR) were calculated. The data were correlated to results obtained in 20 age- and gender-matched healthy subjects. In addition, the data were compared to gastric retention of the radionuclide at 60 min measured by simultaneous scintigraphy. The PSS patients did not reveal electrical disturbances. They even exhibited a significant postprandial decrease in DFIC, bradygastria, and tachygastria (ns) compared to healthy subjects. Over 50% of the PSS patients showed a delayed gastric emptying. However, EGG did not correlate to radioscintigraphy significantly. Our results reflect an absent relationship between antral myoelectrical activity in EGG and gastric emptying. Therefore, electrogastrography is unsuitable to assess gastric involvement in PSS.

Adult↗
PubMed1996

[Eosinophilic gastroenteritis in food allergy].

A 23-year-old woman suffered from chronic abdominal pain, nausea and diarrhea. The clinical symptoms particularly increased after ingestion of several foods. Laboratory investigation revealed a moderate eosinophilia in peripheral blood, elevated serum IgE-level and specific IgE against food allergens in radioallergosorbent testing. The patient exhibited exsudative ascites with eosinophiles. CT scan revealed a thickened wall of the small bowel. There was no evidence of a parasitic or extraintestinal disease. Endoscopically, the gastrointestinal tract appeared normal. Histological examinations of biopsies of the gastrointestinal tract led to the diagnosis of eosinophilic gastroenteritis. Under an elimination diet the patient is symptom-free since 16 months without ascites.

Adult↗
PubMed1995

[Severe pneumonitis as a complication of low-dose methotrexate therapy in psoriasis-associated polyarthritis].

A 71-year-old woman with psoriasis-associated rheumatoid arthritis had for 15 months been treated with methotrexate (5 mg/week orally). Four weeks before admission she had developed dyspnoea and cough. On admission her axillary temperature was 38.2 degrees C, the white cell count was normal. Erythrocyte sedimentation rate (50/90 mm), lactate dehydrogenase activity (449 U/l) and the creatinine level (1.33 mg/dl) were all elevated. Blood gas analysis revealed partial respiratory impairment (pO2 52 mm Hg), and the chest X-ray demonstrated bilateral interstitial-alveolar changes. Despite antibiotics the temperature continued to rise, and on the 11th day a blood eosinophilia of 4% was noted. The bronchial mucosa was normal on bronchoscopy, and transbronchial biopsy showed only minor interstitial fibrosis, occasional macrophages and lymphocytes. Cultures of the lavage-fluid were negative. As methotrexate pneumonitis was suspected the drug was discontinued and prednisolone administered (50 mg daily for 3 days, gradually reducing over 7 days). The symptoms quickly improved, and blood gas analysis and the X-rays became normal. The patient was discharged symptom-free after 30 days.

Acute Disease↗
PubMed1995

[Short-term triple therapy with pantoprazole, clarithromycin and metronidazole for the healing of Helicobacter pylori infection].

In a prospective study 27 patients (13 women, 14 men; mean age 62 [45-83] years) with Helicobacter (H.) pylori associated disease received over 7 days pantoprazole (40 mg twice daily), clarithromycin (500 mg twice daily) and metronidazole (500 mg twice daily). Six patients had gastric ulcer, 4 duodenal ulcer, 4 erosive gastritis, 6 erosive duodenitis and 7 had H. pylori-positive functional dyspepsia. Pre-treatment oesophago-gastro-duodenoscopy was combined in 4 patients with antral and in 4 others with body-of-stomach biopsies to demonstrate H, pylori (urease test, specific culture and histology). The H. pylori status was checked with the 13C-urea breath test 4 weeks after the end of treatment. In addition, 9 patients with peptic ulcer were examined endoscopically at least 2 weeks after onset of the treatment to check for any healing of the ulcers, 25 of the patients completed the study according to the protocol. The H. pylori eradication rate was 100% (25 of 25 patients), while the "intention to treat" analysis gave a rate of 92.6% (25 of the 27 patients). The peptic ulcers were found to be healed in all 9 patients who had been endoscoped. One woman developed a reversible stomatitis, but the drug treatment did not have to be stopped. -These findings indicate that short-term triple treatment in the described manner is efficacious in curing H. pylori infection and any peptic ulcer. It is thus a highly promising treatment of H. pylori-associated diseases.

2-Pyridinylmethylsulfinylbenzimidazoles↗