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Biomedical subjects

M Wegener

Publications and source records attributed to M Wegener.

At least 127 records · Page 7Linked to original sources

Acute colonic pseudo-obstruction (Ogilvie's syndrome). Presentation of 14 of our own cases and analysis of 1027 cases reported in the literature.

In addition to the presentation of 14 of our own patients, this study analyzes 1027 cases with acute colonic pseudo-obstruction reported in the literature from 1948 to 1987. Principal associated diseases are cardiopulmonary insufficiencies, postoperative conditions, and systemic disorders. The syndrome is related to a disturbance of colonic autonomic innervation resulting in gross dilatation of the cecum and the right hemicolon. Therapeutic measures include conservative management, colonoscopic decompression, and surgical procedures. The latter have been associated with high morbidity and mortality. Our data support a nonoperative approach to this condition, including conservative measures and colonoscopic decompression as the initial therapy of choice with few complications and high efficacy.

Aged↗

Comparison of biopsy urease test and histologic examination for detection of campylobacter pylori in duodenal, antral and fundic biopsies.

The presence of Campylobacter pylori was investigated in duodenal, antral and fundic biopsies of 149 consecutive patients undergoing upper gastrointestinal tract endoscopy by biopsy urease tests (CLOtest; "CLO test") and histologic examination ("HIST") after modified Giemsa staining. Positive results were obtained rarely in the duodenum (4.7% and 12.8% by CLO test and HIST, respectively), but equally frequently in antral (48.3% and 62.4%) and fundic biopsies (55.0% and 54.4%). Using combined evaluations ("COMB") of both CLO test and HIST results, and disregarding isolated positive histologic grades "1" as C. pylori negative, the detection rates were 6.0, 53.0 and 56.4% in the above order and 63.1% overall at any of the biopsy sites. There was no close correlation between the rapidity of the color conversion of the biochemical test and the microscopic grading of C. pylori density. A positive CLO test in single antral biopsy specimens was an accurate predictor of the presence of C. pylori as compared with HIST (predictive value positive PVpos 0.97), while negative antral BUT results did not rule out C. pylori colonization of the upper GI tract (PVneg 0.52 compared with HIST). An additional negative CLO test from fundic biopsies increases the PVneg to 0.58.

Adolescent↗

[Significance of serum immunoglobulins for the diagnosis of alcohol-induced liver diseases].

Serum immunoglobulins (IgG, IgA, IgM) were prospectively determined in 524 consecutive patients with degenerative liver damage (mainly steatosis), fibrosis, chronic hepatitis, and cirrhosis, proven by biopsy or visually. Concerning alcohol consumption all patients were assigned to two groups according to previously defined criteria; those with regular alcohol abuse (at least 80 g/d) and those without or with irregular alcohol intake. Serum concentrations of all immunoglobulin classes significantly increased with progredient liver parenchymal destruction from steatosis to chronic hepatitis and fibrosis to cirrhosis. Significant differences in immunoglobulins, especially in IgA, between patients with or without alcohol consumption were not observed. These results indicate that serum immunoglobulin concentrations are related to the degree and not to the etiology (alcoholic/non alcoholic) of liver damage.

Biopsy↗

Colorectal adenomas. Distribution, incidence of malignant transformation, and rate of recurrence.

In 282 patients, 731 colon polyps (643 adenomas and 88 hyperplastic polyps) were extirpated endoscopically or biopsied and investigated histologically. Localization of the adenomas with various degrees of atypia and the hyperplastic polyps, as well as their size distribution, were determined. In 66 patients with adenoma polypectomy on the first examination, one or more control colonoscopies were carried out (in all, 107). The median period of follow-up observation was 31 months. Thirty percent of the one-year control colonoscopies after polypectomy revealed new adenomas. The statistical analyses showed that patients with singular adenomas, on initial investigation, develop significantly fewer adenomas in the further course than patients with multiple initial findings, especially in negative results in the one-year control. The size of new adenomas found during the first 24 months after polypectomy does not exceed 10 mm. On the basis of these results and the literature data available so far, a follow-up program is presented for discussion.

Adenoma↗

Subcutaneous emphysema and pneumothorax complicating diagnostic colonoscopy.

A case of subcutaneous emphysema and pneumothorax secondary to a diagnostic colonoscopy is presented. While 11 cases of retroperitoneal emphysema due to colonoscopy were identified in the literature, there are only two further reports of pneumothorax. Possible etiologic and therapeutic aspects are discussed.

Colonoscopy↗

Methimazole-associated cholestatic liver injury: case report and brief literature review.

The authors report a further case of methimazole-associated liver damage and present a brief review of eleven previous cases found in the literature. The main clinical features of this 58-year-old female patient were laboratory evidence of leucopenia and cholestasis, and biopsy features of fatty liver parenchyma degeneration with granulocytic portal infiltration and bile stasis, demonstrated 20 days after the initiation of antithyroid therapy with 20 mg methimazole daily. An immediate cholestatic liver reaction was also provoked by drug rechallenge, with spontaneous amelioration of signs and symptoms after drug discontinuation.

Cholestasis, Intrahepatic↗

Inhibitory effect of nifedipine on cholecystokinin-induced gallbladder contraction in man.

A prospective study was performed on seven male and eight female patients with normal hepatobiliary findings to investigate the effect of 20 mg nifedipine on cholecystokinin-induced gallbladder contraction. Each patient received 1 IDU (Ivy dog unit) cholecystokinin per kg body weight intravenously on two consecutive days, with additional administration of 20 mg nifedipine sublingually on the second day. Gallbladder volumes were assessed by ultrasonography over a period of 25 minutes. Cholecystokinin induced a maximal reduction in the mean initial volume of 56.8 +/- 3.6%. After nifedipine, this volume change was significantly reduced to 30.9 +/- 5.1% (p less than 0.001). Thus our data suggest for the first time that the calcium-channel-blocking agent nifedipine can have an effect on human gallbladder kinetics.

Adult↗

[Acute pseudo-obstruction of the colon--significance of colonoscopy for diagnosis and therapy].

Acute colonic pseudoobstruction (Ogilvie's syndrome) predominantly involves elderly patients with serious underlying diseases and is defined by massive colonic distention without mechanical obstruction. Therapy of choice included surgical cecostomy with a mortality rate of over 30 percent. Fiberoptic coloscopy provides a new effective treatment modality for colonic decompression. We discuss the cases of 8 patients with Ogilvie's syndrome, who were successfully treated by colonoscopic decompression. Special guidelines for successful and safe performance of the procedure are suggested.

Acute Disease↗

[Heterotopic gastric mucosa of the gastrointestinal tract].

Islets of heterotopic gastric mucosa can occur in the whole alimentary tract as well as in the gallbladder, the extrahepatic bile ducts and the pancreatic tissue. In most cases they have incidentally been discovered in autopsies and surgical specimens. Ectopic gastric mucosa is known to cause gastrointestinal bleeding in Meckel's diverticulum and duplications of the intestine, and, in exceptional cases may show a malignant transformation. In endoscopy of the gastrointestinal tract ectopic gastric epithelium can often be conjectured from certain morphological phenomena. In this paper we review pathogenesis, localization, clinical significance as well as diagnostic and therapeutic aspects of heterotopic gastric mucosa.

Biopsy↗

Modeling urban decline: a multilevel economic-demographic model for the Dortmund region.

"Selected results of a multilevel dynamic simulation model of the economic and demographic development of the urban region of Dortmund [Federal Republic of Germany] are presented. In particular, the capability of the model to capture both urban growth and urban decline processes is illustrated. The mechanisms that control spatial growth, decline, or redistribution of activities in the model are first outlined, and a demonstration of how the model reproduces the general pattern of past spatial development follows. Finally, results of simulations covering a wide range of potential overall economic and demographic development in the region are discussed." (summary in FRE, ITA, JPN, )

Demography↗