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Biomedical subjects

M Wegener

Publications and source records attributed to M Wegener.

At least 109 records · Page 6Linked to original sources
PubMed1990

Gastrointestinal transit disorders in patients with insulin-treated diabetes mellitus.

Gastric emptying, mouth-to-cecum transit and whole gut transit of a solid-liquid meal were measured in 43 insulin-treated diabetics and in 30 control subjects by using scintigraphic techniques, the hydrogen breath test and stool markers. In the diabetics various parameters including duration of diabetes, gastrointestinal symptoms and complications such as autonomic neuropathy, peripheral neuropathy and proteinuria were determined and related to gastrointestinal transit times. Gastric emptying was significantly prolonged in diabetics as compared to the control group (p less than 0.05) with 35% of the diabetics disclosing abnormally delayed gastric emptying, whereas no significant overall differences were observed between diabetics and controls concerning mouth-to-cecum transit and whole gut transit time. However, abnormally prolonged mouth-to-cecum transit was detected in 23% and delayed whole gut transit in 26% of the diabetics (p less than 0.02 as compared to the control group). There was a significant correlation of dyspeptic symptoms and diarrhea with prolonged gastric emptying (p less than 0.001). Gastric emptying, but not mouth-to-cecum transit or whole gut transit was significantly related to autonomic nerve dysfunction (p less than 0.001) and peripheral neuropathy (p less than 0.02). Furthermore, gastric emptying and WGT were significantly correlated to proteinuria (p less than 0.03). Using a linear regression model, autonomic neuropathy, diarrhea and dyspeptic symptoms were the major parameters in predicting delayed gastric emptying. It is concluded that in diabetics different compartments of the gut are affected by gastrointestinal motor abnormalities and that these segments are probably regulated by independent or different control mechanisms.

Adult↗
PubMed1990

[Sonographic assessment of gastric emptying. Reliability and validity of the antrum sagittal surface method for fluids].

The reliability and validity of sonographic measurements of gastric emptying employing sagittal antral planimetry were investigated. The intraindividual reproducibility of this procedure was examined in 15 healthy volunteers, who ingested 400 ml of water on two separate study days. Simultaneous studies of gastric emptying by ultrasound and scintigraphy were performed on 17 of 20 patients with suspected gastroparesis (16 diabetics and one patient with disseminated encephalomyelitis), using a caloric liquid test meal (20 g Biloptin-fatty meal in 300 ml water at 37 degrees C, radiolabeled with 0.5 mCi 99mTc-colloid). The expansion of the antral area with increasing amounts of ingested fluid and the emptying times showed a good intraindividual reproducibility from day to day (r = 0.94 vs. r = 0.81). There was a significant correlation between the relative residual volumes calculated by scintigraphy and by ultrasound (r = 0.82). These results imply that the ultrasonic sagittal antral area method is reliable and valid in the assessment of gastric emptying rates in humans.

Adult↗
PubMed1989

Frequency of idiopathic gastric stasis and intestinal transit disorders in essential dyspepsia.

Gastric emptying, mouth-to-cecum transit (MCT), and whole-gut transit of a solid-liquid meal was measured in 30 control subjects and in 43 patients with essential dyspepsia, in whom organic digestive diseases and secondary disorders of gastric emptying had been excluded. The rate of gastric emptying was determined by an anterior gamma camera technique, MCT by the hydrogen breath test, and whole-gut transit by the first appearance of stool makers. Approximately 30% of patients with essential dyspepsia, predominantly women, in whom statistical analysis failed to reveal any specific pattern of symptoms, had significantly delayed gastric emptying suggesting idiopathic gastric stasis. Concerning MCT and whole-gut transit, significant differences between the control and study group could not be detected.

Adolescent↗
PubMed1988

Clinical evaluation, ultrasound, cholescintigraphy, and endoscopic retrograde cholangiography in cholestasis. A prospective comparative clinical study.

The accuracy of clinical evaluation (CE), ultrasonography (US), and cholescintigraphy (CS) was prospectively compared in a group of 72 cholestatic patients, using the results of endoscopic retrograde cholangiography (ERC) as the true standard. Forty-six cases (63.9%) had a final diagnosis of extrahepatic biliary obstruction. Clinical evaluation had a sensitivity of 82.6% and a specificity of 46.2% for the identification of mechanical obstruction. Ultrasonography was the single most powerful noninvasive diagnostic procedure, with a sensitivity of 65.2%, a specificity of 92.3%, a positive likelihood ratio of 8.5, and a positive predictive value (PVpos) of 93.8%, which was superior to the diagnostic power of CS (0.05 less than p less than 0.1). Inconclusive results or technical failures were counted as diagnostic errors. Contingency table analyses in an extended group of 112 patients, complete for CE, US, and CS, revealed that concordant results of CE and US had a high probability of correctness (combined PVpos 92.6%, PVneg 98.0%). Contradictory ratings of these two tests were unlikely to be clarified reliably by additional CS. We conclude that the combined evaluation of CE and US allows an accurate differentiation between intrahepatic cholestasis and extrahepatic biliary obstruction. When both give contradictory results, direct cholangiography, rather than further noninvasive procedures, appears to be the diagnostic strategy of choice.

Aged↗
PubMed1988

Campylobacter pylori: prospective analysis of clinical and histological factors associated with colonization of the upper gastrointestinal tract.

The association of Campylobacter pylori (C.p.) colonization of the upper gastrointestinal tract with five predefined anamnestic variables, seven symptoms of dyspepsia, and various blindly evaluated histological criteria, was prospectively investigated in a consecutive series of 149 patients submitted to upper gastrointestinal tract endoscopy. Colonization was determined by biopsy urease tests and histological searches. Significant differences (P less than 0.05) between C.p.-positive and C.p.-negative patients were found for smoker status and the frequency of therapy with ulcer-healing drugs (positive association with C.p.) and antibiotics (negative association), but not for any other of the anamnestic data or symptoms. These data were further submitted to stepwise multiple logistic regression analyses. Concerning histological findings, C.p. colonization was significantly associated with the degree of antrum and body gastritis (P less than 0.01), and also with lymphocellular infiltration in antrum and body biopsies and neutrophil cellular grading in gastric antra. We conclude that C.p. colonization of the upper gastrointestinal tract is associated with gastritic change of the antrum and, albeit to a lesser extent, of the body mucosa. However, a specific pattern of symptoms to predict C.p. colonization could not be established.

Adolescent↗
PubMed1988

Effect of ageing on the gastro-intestinal transit of a lactulose-supplemented mixed solid-liquid meal in humans.

Gastro-intestinal transit of a mixed solid-liquid meal containing wheat bread, scrambled eggs, coffee labelled with 99mTc, orange juice with lactulose and indigocarmine was evaluated in 21 young control (mean age 33.5 years) and 25 elderly subjects (mean age 81.7 years) without gastrointestinal complaints or severe medical illness. The rate of gastric emptying was determined by an anterior gamma camera technique, mouth-to-caecum transit by the hydrogen breath test and whole-gut transit by the first stool passage of indigocarmine. Gastric emptying was significantly prolonged in older subjects: t1/2 = 136 +/- (SEM) 13 versus 81 +/- 4 min; p less than 0.001. Concerning mouth-to-caecum or whole-gut transit time, significant differences between the two study groups were not detected.

Adult↗
PubMed1988

[Campylobacter pylori-associated chronic gastritis: a new entity in gastroduodenal diseases?].

Clinical, morphological and immunological data in addition to animal studies clearly support the conclusion, that Campylobacter pylori infection is a direct cause (sufficient condition) for chronic type B gastritic in man. C. pylori gastritis is primarily a histologic entity defined by the presence of a gastric mucosal cellular infiltrate and the histologic demonstration of typical curved bacilli. Preliminary findings indicate, that this infection is not associated with a specific combination of symptoms. Also, it is not exclusively confined to human beings, since this or similar infections appear to represent a rather common phenomenon of mammalian stomachs. The emergence of C. pylori gastritis as a distinct entity may give rise to a new classification of dyspeptic disorders based on etiologic considerations. However, the clinical impact of C. pylori will in all likelihood depend primarily on the as yet unestablished therapeutic potential to effectively eradicate the organisms.

Campylobacter↗
PubMed1988

Are dyspeptic symptoms in patients with Campylobacter pylori-associated type B gastritis linked to delayed gastric emptying?

In this paper, the association of gastric Campylobacter pylori (CP) colonization with histologic findings and gastric emptying of a mixed solid-liquid meal was prospectively investigated in 43 consecutive patients with essential non-ulcer dyspepsia (ENUD). Gastric emptying was also measured in 30 symptom-free control subjects. The frequency of CP infection in patients with ENUD was 44.2%. We found a strong association between gastric CP colonization and chronic antral type B gastritis. Although gastric emptying was significantly prolonged in patients with ENUD, compared with the control group (p less than 0.05), we could not detect significant differences of gastric emptying between CP-negative and CP-positive ENUD patients, both groups disclosing a similar proportion of patients with significantly delayed gastric emptying (29.2% vs 31.6%). We therefore conclude that delayed gastric emptying of a mixed solid-liquid meal is not correlated with CP-positive chronic antral type B gastritis, and does not help to explain dyspeptic symptoms, which may possibly arise in relation to gastric CP colonization.

Adult↗
PubMed1987

Gallbladder wall thickening: a frequent finding in various nonbiliary disorders--a prospective ultrasonographic study.

A comprehensive prospective ultrasonographic study was performed in 93 patients to investigate gallbladder wall thickness and gallbladder volumes in various nonbiliary disease states. Without changes in gallbladder volume, mean gallbladder wall thickness was significantly increased (p less than 0.01) in patients with liver cirrhosis, viral hepatitis, chronic congestive heart failure, hypoalbuminemia, and chronic renal failure (p less than 0.05) but not in patients with diabetes mellitus (n = 14) as compared to a control group. The present study confirms that a variety of nonbiliary disorders are associated with significant thickening of gallbladder walls and that this finding is not caused by incomplete gallbladder contraction.

Diabetes Mellitus↗