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Biomedical subjects

M Wegener

Publications and source records attributed to M Wegener.

At least 91 records · Page 5Linked to original sources
PubMed1992

[Endosonographically directed transesophageal fine needle aspiration in diagnosis of mediastinal para-esophageal space-occupying processes].

Endoscopic ultrasonography with high-frequency ultrasonic beams allows detailed study of the gastrointestinal wall structures and the surrounding Tissues. Moreover most echoendoscopes carry a biopsy channel for biopsy or cytologic puncture guided by endoscopic ultrasonography. We present a patient with a tumor in the posterior mediastinum in whom conventional diagnostic techniques failed to obtain speciments for cytologic evaluation. Transesophageal fine needle aspiration guided by endoscopic ultrasonography confirmed the diagnosis of lung cancer consisting of adeno and small cells in this patient. Transesophageal fine needle puncture guided by endoscopic ultrasonography might become a valuable aid for the diagnosis of tumor masses in the posterior mediastinum.

Aged↗
PubMed1992

Effect of hyperthyroidism on the transit of a caloric solid-liquid meal through the stomach, the small intestine, and the colon in man.

Gastric emptying, mouth-to-cecum transit, and whole gut transit of a solid-liquid meal was measured in 20 hyperthyroid patients and in 30 control subjects by using scintigraphic techniques, the hydrogen breath test, and stool markers. In the hyperthyroid patients predefined gastrointestinal symptoms were determined and related to gastrointestinal transit. There was no significant overall difference of gastric emptying between the hyperthyroid patients and the control subjects, whereas both mouth-to-cecum transit time (mainly reflecting small intestinal transit) and whole gut transit time (mainly reflecting large intestinal transit) were significantly accelerated in hyperthyroid patients as compared to the control subjects (P less than 0.005). Mouth-to-cecum transit in hyperthyroid patients with diarrhea tended to be more rapid than in those without diarrhea (P = 0.094) and the T3 concentrations were inversely correlated with mouth-to-cecum transit time. It is concluded that in thyrotoxicosis 1) small and large intestinal transit is accelerated, while gastric emptying remains unchanged and 2) rapid intestinal transit is likely to be one factor among others implicated in the generation of diarrhea.

Adult↗
PubMed1992

[Gallbladder motility in diabetic patients with and without cardiovascular neuropathy].

In 50 diabetic patients without gallstones, including 26 patients with cardiovascular autonomic dysfunction, and 60 normal volunteers the fasting volume and volume reduction of the gallbladder after a liquid fatty meal were determined ultrasonically in intervals of ten minutes up to one hour. Simultaneously the gastric emptying of the liquid meal was followed by ultrasound imaging. Despite an association of other complications of diabetic disease (peripheral neuropathy, retinopathy) with autonomic cardiovascular dysfunction, an altered gallbladder resting volume or impaired fat-induced volume reduction was not evident in this group of patients when compared the diabetics without cardiovascular dysfunction or controls. The time to reach the minimal residual gallbladder volume was only tendentiously prolonged in diabetics with autonomic cardiovascular dysfunction. The residual volume of the stomach showed no significant difference between the three study groups using a liquid test meal. In conclusion neuropathic dysfunction of the gallbladder is unlikely to play a major pathogenetic role in the development of gallstones in diabetic patients.

Adult↗
PubMed1992

[Modified combined omeprazole/amoxicillin therapy for Helicobacter pylori eradication: a pilot study].

Patients with H.pylori positive peptic ulcer disease were treated with a two weeks regimen consisting of 20 mg omeprazole twice daily and 500 mg amoxicillin six times daily. Subsequently, an H2-receptor antagonist was started (300 mg ranitidine) at night time for four weeks. Before and one month after completion of antibiotic therapy an upper GI-tract endoscopy was performed for determination of H.pylori infection [biopsy urease test (BUT), specific culture and histologic demonstration]. A total of 12 patients completed the study protocol. H.pylori eradication, defined as a negative result in BUT, culture and histology) four weeks after completion of the combined omeprazole/amoxicillin treatment regimen was achieved in 91.6% (11 of 12 patients). Complete ulcer healing was confirmed in all patients. A stomatitis was observed in one female patient as a possible side effect of antibiotic treatment, but this did not necessitate discontinuation of therapy. Only complicated drug regimen with many side effects have been available so far for successful eradication of H.pylori. Thus, the present drug combination might prove as an effective therapeutic option in the future. These data, however, await confirmation in larger study population.

Adult↗
PubMed1992

Does physical exercise influence bowel transit time in healthy young men?

An examination was performed on 20 healthy men, who had a specific diet, to test the influence of moderate physical activity on bowel transit. During a 3-day pause and a 3-day phase of easy sports activity (jogging), oro-anal transit was measured with the help of radiopaque markers (Hinton method). While the subject was under exertion, the entire weight of stool rose significantly (743 vs. 600 g), whereas we found no significant influence on the oro-anal transit time (39 vs. 48 h) or on stool frequency (1.3 vs. 1.3 per day). Moderate physical activity had no effect on bowel transit time of healthy men under a constant diet. The effect of the so often recommended increase of physical activity on constipation remains to be elucidated.

Adult↗
PubMed1992

[Splenic rupture following colonoscopy: an unusual complication].

A case of splenic rupture after an uneventful diagnostic colonoscopy in a 68-year old man is reported. Conservative management of this complication was successful. Splenic rupture is a unique and severe complication of colonoscopy, which can rarely be managed conservatively.

Aged↗
PubMed1991

[Diagnostic value of ultrasonographic testing of the gallbladder function in cholelithiasis].

Decrease in gall-bladder volume after intake of a test meal was assessed by ultrasound in 30 patients (24 females, 6 males; mean age 55 [22-82] years) with indications for elective or early elective cholecystectomy for cholelithiasis. Patients were assigned to three groups, based on intraoperative and histological gall-bladder changes: group 1 (n = 17), without changes or with mild chronic cholecystitis; group 2 (n = 4), with severe chronic inflammatory changes; group 3 (n = 9), with acute cholecystitis or cystic duct occlusion. A volume decrease of at least 30% after the test meal excluded only acute wall inflammation (negative predictive value 95.5%), while a volume reduction of at least 50% made it possible in a high percentage of cases (negative predictive value 88.2%) to predict correctly an absence of severe chronic wall changes. Before organ-preserving treatment (extracorporeal lithotripsy or local litholysis) is undertaken, gall-bladder volume reduction of at least 50% should be documented.

Acute Disease↗
PubMed1991

[Carcinoembryonic antigen (CEA) in ascites].

The diagnostic value of carcinoembryonic antigen (CEA) was studied prospectively in 18 patients with ascites of malignant and 28 patients with ascites of benign genesis. Both sensitivity and specificity reached 83%. With a prevalence of malignant disease of 38%, the positive and negative predictive values were 75% and 89%, respectively. In contrast to frequent false-positive CEA values in the serum of liver cirrhotics (48.3%), false-positive CEA values in the ascites of the same patients were observed in only 17.3%. It is thus recommended that if CEA determination is to be employed, it should be done in the ascites itself.

Ascites↗
PubMed1991

Gastrointestinal transit of solid-liquid meal in chronic alcoholics.

Gastric emptying, mouth-to-cecum transit, and whole-gut transit of a solid-liquid meal were measured in 46 chronic alcoholics and in 30 control subjects by using scintigraphic techniques, hydrogen breath test, and stool markers. In the alcoholics various parameters such as ethanol consumption, gastrointestinal symptoms, and alcoholic neuropathy were determined and related to gastrointestinal transit times. Although there was no significant overall difference of gastric emptying, abnormally delayed gastric emptying was detected in 23.9% of the alcoholics but no control subject (P less than 0.005). Mouth-to-cecum transit was significantly prolonged in the alcoholics (P less than 0.001) with 14 alcoholics (37.8%) disclosing delayed mouth-to-cecum transit. No significant differences between both groups were detected concerning whole gut transit. In the alcoholics there was a significant correlation of dyspeptic symptoms with delayed gastric emptying (P less than 0.006), and alcoholics with diarrhea had an accelerated mouth-to-cecum transit as compared to those without diarrhea (P less than 0.05). Neither the presence of autonomic or peripheral neuropathy nor the presence of liver cirrhosis or ascites was significantly related to gastrointestinal transit times. However, the daily ethanol ingestion significantly correlated with gastric emptying (P less than 0.005). It is concluded, therefore, that in chronic alcoholics the small intestine and the stomach are most likely to be affected by gastrointestinal transit disorders and that these transit abnormalities are potentially related to toxic damage of gastrointestinal smooth muscle.

Adult↗
PubMed1991

[Fasting volume and contractility of the gallbladder after total and subtotal gastrectomy with Y-Roux anastomosis. A prospective study].

Gallbladder volume and contraction after a fatty meal was determined in 14 patients with gastric cancer before and 3-4 months after gastrectomy (7 total and 7 subtotal gastrectomies) with Roux-en-Y anastomosis. All patients had an increased gallbladder resting volume (p less than 0.001) and 10 of 14 patients (6 after total gastrectomy and 4 after subtotal gastrectomy) had an increased minimal residual volume after fatty meal stimulation (p less than 0.01) in the postoperative state, when compared to the preoperative values. It can be concluded that gastrectomy is followed by an impairment of gallbladder tone and contraction, both possibly increasing the risk of gallstone formation.

Adult↗
PubMed1991

Effects of age and gender on fat-induced gallbladder contraction and gastric emptying of a caloric liquid meal: a sonographic study.

In this study, the gastric emptying of a liquid fatty meal and the consecutive gallbladder contraction were simultaneously measured by ultrasound in four different age- and sex-related groups of normal subjects: group A, 15 women less than 50 yr (premenopausal); group B, 15 women greater than 50 yr (postmenopausal); group C, 15 men less than 50 yr; and group D, 15 men greater than 50 yr. Apart from a significantly delayed gastric emptying in the premenopausal women, no significant differences in the postprandial relative gallbladder emptying rates were observed between the four study groups. Ninety-five percent of all study subjects had a gallbladder volume reduction of more than 50% after a liquid fatty meal. It is therefore concluded, that 1) endogenous or contraceptive female sex hormones may have a delaying effect on gastric emptying of caloric liquids in the premenopausal state, 2) aging or gender do not significantly influence the fat-induced gallbladder contraction in man, and 3) a 50% residual volume of the gallbladder after a fatty meal should be considered as the upper limit of normal gallbladder contractility (95 percentile of a normal collective).

Adult↗