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Biomedical subjects

W Berges

Publications and source records attributed to W Berges.

At least 19 recordsLinked to original sources
PubMed1992

Treatment results of the thioether lipid ilmofosine in patients with malignant tumours.

In a multicentre study patients with liver metastases stratified to the histology of the primary tumour were investigated. A total of 102 patients with colorectal adenocarcinoma, non-small-cell lung cancer, pancreatic cancer, primary liver carcinoma and malignant melanoma were treated with the thioether lipid ilmofosine. The drug was administered orally as a tablet at a dosage of 150-300 mg/day (75 mg/tablet). The tolerability of ilmofosine was poor. There was a dose-limiting gastrointestinal toxicity with nausea, vomiting and loss of appetite (WHO grade II-IV) in 67% of patients. During the period of therapy (1-29 weeks, 8.5 weeks mean) no complete remission and no partial response were observed. We thus conclude that treatment with oral ilmofosine is not effective in patients with liver metastases due to various malignancies.

Adenocarcinoma↗
PubMed1990

[Disorders of esophageal function as a cause of thoracic pain].

Oesophageal disorders can be identified in about one third of the patients with non cardiac chest pain. Motility disturbances and gastro-oesophageal reflux are the leading causes of chest pain of oesophageal origin. Heart diseases and organic lesions of the oesophagus have to be ruled out by cardiological examination and endoscopy, respectively. Oesophageal motility testing and long-term-pH-metry are useful to further characterize the underlying functional disorder. Because of the spontaneous fluctuations of symptoms and the effects of placebo treatment therapy should be conservative and based on the results of these investigational procedures.

Chest Pain↗
PubMed1990

Crohn's disease in four members of a family, two of whom are dizygotic twins.

Familial occurrence of Crohn's disease (CD) is well known, but the disease is rarely reported to occur in dizygotic twins. We present an additional case of dizygotic twins, both of whom developed CD, from a family in which two other members are affected. The 16-year-old son contracted the disease 2 years before his 50-year-old father, and 13 years before his twin sister. Another sister was affected 6 years after the onset of the disease in the propositus. HLA haplotyping of the three children matched the Mendelian ratio. The multiple occurrence of CD in blood relatives, especially in siblings, emphasizes the importance of genetic factors in the development of this disease. This family history, however, could point to psychic influences promoting the occurrence of CD on the basis of a polygenic disease susceptibility.

Adolescent↗
PubMed1990

Prevalence of lactose malabsorption among patients with functional bowel disorders.

To investigate the prevalence of lactose malabsorption among patients with functional gastrointestinal disturbances we prospectively evaluated all patients referred to a gastrointestinal outpatient clinic over a period of 18 months. All patients had a breath hydrogen test following oral lactose in addition to the standard diagnostic procedures. In 37 of the total of 64 patients no organic cause of the gastrointestinal complaints was found. In 9 of these 37 patients (24%) the breath hydrogen test indicated lactose malabsorption. Three to 6 month later most of the patients with lactose malabsorption showed a significant reduction of gastrointestinal complaints after they had maintained a lactose-poor diet. In comparison, patients with functional disturbances but without lactose malabsorption reported nor or only minor improvement of symptoms; most of these patients had consulted another physician since the last visit in the clinic.

Breath Tests↗
PubMed1989

[Rectal stenosis due to long-term therapy with ergotamine].

Two patients (a woman aged 39, a man aged 46 years) had developed severe distal rectal stenoses after 20 years of anti-migraine treatment with ergotamine-containing suppositories. The woman required several bougie and laser treatments. In the man a megacolon had developed due to increasing, finally complete, rectal stenosis and this required a double colostomy (transverse colon) as an emergency. Ergotamine-containing suppositories are widely used in the treatment of migraine, but they should not be administered for prolonged periods.

Adult↗
PubMed1989

[Diagnosis of achalasia--comparison of methods for the evaluation of severity].

To determine the value of endoscopy, manometry, and scintigraphy in predicting the severity of achalasia, 25 patients with primary achalasia of the esophagus were posprectively studied; 17 patients could be examined prior and post pneumatic dilatation. According to the symptoms, the severity was graded from I to IV. While endoscopic findings did not well correlate with the symptom score, the lower esophageal sphincter pressure and the resting pressure in the esophageal body were significantly correlated with the severity of the disease (p less than 0.01). The esophageal retention of radioactivity rose parallel to the symptom score (p = 0.07). Both manometric and scintigraphic findings changed significantly after therapy (p less than 0.01). Manometry and scintigraphy of the esophagus can be used to measure treatment related effects in patients with primary achalasia. Endoscopic findings are not related to subjective complaints, but an endoscopic examination should always be performed to exclude malignancies of the esophago-gastric junction.

Adult↗
PubMed1989

[The aorto-enteric fistula--a rare, but important cause of upper gastrointestinal hemorrhage].

During the last two years two patients with upper gastrointestinal bleeding caused by an aortoenteric fistula were admitted to the hospital. The first patient had a primary fistula between an arteriosclerotic aneurysm of the abdominal aorta and the duodenum. The second patient had an infected aortobifemoral graft which had penetrated into the upper jejunum. The aortoenteric fistula is one of the very rare causes of upper gastrointestinal bleeding. Referring to previous surgery at the aorta a primary and secondary type of fistula are differentiated. The primary fistula often induces a small initial bleeding followed by a severe hemorrhage with hematemesis and melaena. The secondary form is mostly caused by bacterial infection of the graft. Recurrent fever attacks are a common clinical symptom without any evidence of the origin of the bacteriemia. Principally the combination of upper gastrointestinal bleeding and aortic graft is always suspicious of an aortoenteric fistula. The most important preoperative examinations are endoscopy, computed tomography scan, and arteriography. The treatment must be surgical. Either a synthetic graft surrounded by omentum is implanted or an axillobifemoral or aortobifemoral bypass is constructed. Even if the diagnosis is made early mortality of the disease is about 20-30%.

Aged↗
PubMed1988

[Achalasia as a mask of cardial carcinoma].

Increasing dysphagia and weight loss between 3 and 30 kg developed in eight patients aged 27-70 years (mean age 53 years) within a period of 1.5 to 12 months. In five patients X-ray film showed the typical pattern of achalasia with dilatation of the tubular oesophagus and a smooth taper of the terminal part. Although in all patients the cardia became patent only after the endoscope had been advanced by pushing it forward to overcome stenosis or after bougienage, and although the malignoma had always been included in differential diagnostic considerations, a malignoma was identified only three times in 30 histological examinations. Oesophageal manometry demonstrated findings characteristic of achalasia in five patients, in three patients the examination could be performed only incompletely. In six patients computed tomography revealed pathological hypertrophy of the cardiac wall. Intraoperatively all cardiac tumours were in an advanced stage.

Adult↗
PubMed1988

[Orthotopic liver transplantation in Wilson's disease and acute liver failure].

Liver histology demonstrated progressive cirrhosis in a 19-year-old girl with a subacute form of Wilson's disease. Despite D-penicillamine administration her liver functions rapidly deteriorated further. Orthotopic liver transplantation was performed. Postoperatively there were two mild rejection episodes, an organic psychiatric syndrome and generalized tremor. Copper metabolism and clinical symptoms became normal postoperatively. Five months after the transplantation she was in a good general condition, able to continue her education.

Acute Disease↗
PubMed1988

Drug-induced oesophageal lesions.

Persisting retrosternal pain of sudden onset is suggestive of a drug-induced oesophageal lesion, particularly if it starts at night. After exclusion of a myocardial infarction, a carefully taken history and oesophagoscopy will rapidly clarify the cause and severity of the injury. Since almost any pill may produce oesophageal lesions, care has to be taken that tablets, capsules and other pills are always taken in an upright position together with a fluid chaser of at least 120 ml. If possible, less harmful liquid preparations of the drugs should be preferred. Lesions in the oesophageal wall and perioesophageal tissue are almost unavoidable side-effects of sclerotherapy of oesophageal varices. The patient and the doctor should be particularly aware of bleeding from oesophageal ulcers during the first week after sclerotherapy. Numerous drugs may weaken or strengthen contractions of the oesophagus and lower oesophageal sphincter. These potentially unwanted motor effects of the drugs have to be kept in mind, especially in patients with pre-existing gastro-oesophageal reflux disease and hypermotility states.

Drug-Related Side Effects and Adverse Reactions↗
PubMed1988

Family occurrence of achalasia and diffuse spasm of the oesophagus.

In view of the unknown aetiology of achalasia and diffuse oesophageal spasm we report four families (father/son, mother/son, brother/brother, cousin/cousin) with achalasia and oesophageal spasm examined by radiology, endoscopy and manometry. Family occurrence of oesophageal motor disorders supports the hypothesis that a genetic trait may play a role in the pathogenesis. The family coincidence of achalasia and oesophageal spasm supports a close relationship between the two diseases.

Adult↗
PubMed1988

Computer analysis of pressure tracings from the sphincter of Oddi.

Since the sphincter of Oddi exhibits very regular phasic motor activity it offers itself to the design of a simple computer program in the analysis of gastrointesinal motility. This investigation is the first attempt of a practical application of such a computer program. The signals coming out of the pressure preamplifier are submitted to active filtering in order to prevent aliasing and then to analog to digital conversion. After being fed into a computer they are precessed in a number of controllable and adaptable steps before the final analysis. Computer analysis then yields a detailed quantitative print out of a large variety of variables which compares very favourably with the visual analysis. It speeds up the time of analysis and allows for a study of long-term recording. Computer analysis of pressure tracings from the sphincter of Oddi may serve as a model for a study of motor activity of all parts of the digestive tract with this modern method of data handling.

Ampulla of Vater↗