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Biomedical subjects

S E Miederer

Publications and source records attributed to S E Miederer.

At least 55 records · Page 3Linked to original sources
PubMed1978

[Endoscopic transpapillary splitting of a choledochocele (author's transl)].

A choledochocele with obstruction to outflow from the biliary and pancreatic duct systems was diagnosed by endoscopic retrograde cholangio-pancreatography in a 67-year-old man with radiating upper-abdominal pain and constantly elevated gamma-glutamyl transferase. After distension of the choledochocele with contrast medium a papillotome was introduced across the papilla and the choledochocele was split open. There were no complications and flow from both systems became normal. The symptoms disappeared and the patient required neither anaesthesia nor an abdominal operation.

Aged↗
PubMed1978

Experiences and problems in the disinfection of fibre endoscopes.

The problem of the disinfection of fibre endoscopes is to achieve a good efficiency together with easy handling. There is not yet a disinfectant which shows a sufficient germicidal effect after a short time of contact with the fibre endoscope and which is harmless to the patient and medical staff. This paper deals with a two-stage disinfecting procedure in which the instrument undergoes a short intermediate disinfection using polyvidoneiodine (Betaisodona) between two investigations and a main disinfection at the end of a series of investigations using glutardialdehyde (Cidex). The measures lead to a sufficient reduction of the number of germs. The importance of the disinfection of all parts of the endoscopes, especially the channels and the accessories (water bottles etc.) is pointed out.

Aldehydes↗
PubMed1978

[Intramural pseudo-diverticulosis of the oesophagus (author's transl)].

A 58-year old patient with intramural pseudo-diverticulosis of the oesophagus was observed for three and a half years. The case is described and illustrated. The pathogenesis of the disease is discussed with reference to the literature. The radiological appearances permit a definite diagnosis. The oesophagus had a stricture at the level of the bifurcation of the trachea, but in addition there were multiple intramural, sharply demarkated mucosal herniations measuring 3 x 1 mm. These could be verified endoscopically. Histologically, non-specific oesophagitis was found.

Biopsy↗
PubMed1978

Case report: chenodeoxycholic acid therapy of intrahepatic radiolucent gallstones in a patient with Caroli's syndrome.

A 28-year-old man with intrahepatic cystic dilatations of the biliary tree (Caroli's syndrome) which contained multiple radiolucent gallstones was treated with 1 g of chenodeoxycholic acid per day. He had undergone cholecystectomy 4 years and surgical exploration of the common bile duct with papillotomy 2 years prior to chenodeoxycholic acid therapy. While no decrease in the number of stones could be detected by retrograde cholangiography 2 years after papillotomy, most of the stones had disappeared after 2 years of treatment with chenodeoxycholic acid.

Adult↗
PubMed1977

Radiographical and endoscopical studies on two cases of intraluminal diverticulum of the duodenum.

Case report of two intraluminal diverticula of the duodenum. It is a rare congenital lesion characterized by a double layered mucosal sac lying in the duodenal lumen near the ampulla of Vater. Clinical features and laboratory findings are uncharacteristic. X-ray examination is the diagnostic method of choice, endoscopy will give further information about inflammation, haemorrhage and localisation of the ampulla. Treatment of choice is either surgical excision or endoscopical splitting of the diverticulum.

Adult↗
PubMed1977

Multicentric early gastric carcinoma mimicking type I (10 years after B-I-surgery).

10 YEARS AFTER B-I-partial gastrectomy for a proven benign gastric ulcer a multicentric early gastric carcinoma type II b, c was detected by endoscopy and histology. This early carcinoma differed from published cases in respect of its macroscopic classification, localization and expansion. The carcinoma situated next to the anastomosis invaded the duodenal mucosa. It also invaded a polypoid fold caused by the previous surgery, thus imitating an early gastric carcinoma type I.

Adenocarcinoma, Mucinous↗
PubMed1976

[Comparative study on the effect of anticholinergic substances on basic gastric secretion as well as on gastric secretion stimulated by pentagastrin or hypoglycemia (author's transl)].

The effect of orally administered ipratropiumbromide and propanthelinbromide on the basic gastric secretion as well as on the gastric secretion stimulated by pentagastrin or hypoglycemia due to application of insulin was tested intraindividually in a double blind comparative study. Drug dosage and time after the drug effect was measured varied. In addition the anticholinergic effect of ipratropiumbromide on the basic as well as on the gastric secretion stimulated by pentagastrin was compared to that of oxacepam. The inhibitory effect of ipratropiumbromide on the basic gastric secretion as well as on the secretion stimulated by pentagastrin and hypoglycemia is more pronounced than that of propanthelinbromid. The effect on the basic secretion reached its peak 450 min after drug application whereas the maximal effect on pentagastrin stimulated secretion showed earlier. The effect described was only seen with a dose of the anticholinergic drug of at least 30 mg. A combination of ipratropiumbromide+oxacepam has no effect stronger than ipratropiumbromide alone. On the contrary, it rather seems to have an augementative effect on pentagastrin stimulated gastric secretion that may be compensated completely by ipratropiumbromide. On the basic of these results a direct influence of anticholinergic substances on the parietal cell is discussed.

Adult↗
PubMed1976

Disinfection procedures of fiberscopes in endoscopy departments.

Disinfection of fibre endoscopes was examined in 5 endoscopy departments during endoscopy sessions. On the endoscopes, especially in the instrument channels, Pseudomonas aeruginosa and Proteus species could be regularly found, in some cases also Enterobacter cloacae and Candida albicans. With the results of disinfection experiments, proposals are made to reduce the infection risk due to insufficiently disinfected instruments in endoscopy departments.

Bacteriological Techniques↗
PubMed1976

[Pancreatitis and papillary stenosis: endoscopic retrograde pancreatography (ERP) vs. exocrine functional tests (author's transl)].

Functional tests and ERP were performed in patients with chronic and acute pancreatitis and papillary stenosis; both diseases differ considerably as can be shown by both, pancreatography and degree of functional impairment. The different classification types of pancreatitis are based upon the Marseille Symposium. The ERP is the only x-ray procedure which allows the diagnosis of intrapapillar pancreatic duct stenosis. The ERP significantly improves diagnosis of the early stages of papillary stenosis of the pancreas. Neither secretin-pancreozymin test nor ERP are indicated in cases of primary chronic calcifying pancreatitis; in chronic relapsing calcifying pancreatitis they should be used for preoperative diagnostic purposes.

Adult↗
PubMed1976

[The use of the liver-spleen-scan for the diagnosis of congenital Intrahepatic cysts of the bile duct (M. Caroli) (authors transl)].

After the short review of the pathogenesis, diagnosis and therapy for congenital intrahepatic cysts of the bile-duct (morbus Caroli), reference was made to the diagnostic significance of liver scintigraphy on the basis of two casuistic reports. Liver scintigraphy permits an exact localization of intrahepatic cysts as well as information regarding the course of the hepatopathy connected with morbus Caroli. In addition, 131-J-bromsulfon scintigraphy of the liver is a simple method for controlling the patency of the bile ducts. Our observations tend to indicate that preoperative and postoperative scintigraphic controls of the liver are practical for this disease.

Adult↗
PubMed1975

[Determination of chymotrypsin in the stool by succinyl-L-phenylalanin-P-nitraniliden (Suphepa) in the diagnosis of pancreatic diseases (author's transl)].

A specific substrate (Suphepa), which is well known in duodenal chymotrypsin determination (pancreozymin-secretin-test), is also suitable for the enzyme determination in stools from patients suspected of having a pancreas insufficiency of exocrine nature. The median value of 353 fecal chymotrypsin determination of 180 normal persons was 137 mug/g of native stool. There is a good correlation in comparing the fecal with the duodenal chymotrypsin: Out of 30 comparable patients, 10 patients had pathological values for the duodenal and fecal chymotrypsin determinations, whereas 18 patients had normal values. According to the results of the pancreozymin-secretin-test, false normal stool results were recorded for two patients. No false positive stool values were recorded for the comparative collective. The great accuracy, the modest instrumental expense and the negligible inconvenience for the patient are good in line with the requirements for a screening test.

Acute Disease↗
PubMed1975

[Antral morphology and serum-gastrin levels in achlorhydria].

38 patients were found to have achlorhydria after maximal stimulation with pentagastrin and on multiple biopsies (atrophy of gastric mucosa). It was demonstrated that the sequence pH-antroreceptors-G cells-parietal cells-pH antroreceptors was interrupted already in mild or moderately severe superficial gastritis of the antral mucosa involving more than half of the antral surface. Reduction of specific functional epithelium is unlikely in this form of inflammation so that it is probably an effect of the pH receptors.

Achlorhydria↗