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Biomedical subjects

W Rösch

Publications and source records attributed to W Rösch.

At least 19 recordsLinked to original sources
PubMed1992

[Therapeutic strategy in malignant polyps of the gastrointestinal tract].

Malignant polyps in the stomach are identical with early gastric carcinoma type I and IIa. Even if carcinomatous growth is restricted to the mucosa lymph node, metastases may occur; therefore, local measures like polypectomy or surgical excision are exceptional. Malignant gastric polyps should be treated according to classical tumour surgery. Things are different in malignant colonic polyps, i.e. adenomas with a carcinoma invading the submucosa. Unless one is dealing with a dedifferentiated carcinoma or invasion of lymph or blood vessels is seen a few millimetre of security are sufficient to save the patient from radical surgery.

Algorithms↗
PubMed1992

[Spontaneous perforation of ulcers after gastroscopy].

Six cases of spontaneous perforation of penetrating gastric and duodenal ulcers following insufflation of air during gastroscopy are reported. Despite the favorable situation (empty stomach, rapid diagnosis), the prognosis of this complication is relatively poor, since the patients involved are often elderly, have multimorbidity and represent a high surgical risk.

Abdomen, Acute↗
PubMed1992

Pharmacokinetics of azosemide in patients with T-drain after cholecystectomy.

In an open clinical trial the pharmacokinetics of orally administered azosemide (2-Chloro-5-(1H-tetrazol-5-yl)-4-[(2- thienylmethyl)amino] benzene sulfonamide. Luret, CAS 27589-33-9) was surveyed in a group of 10 patients with T-drain after cholecystectomy. The mean peak concentration was reached after 2.35 h (SE: 0.25 h) and was 474 ng/ml (142 ng/ml). The plasma elimination half-life was estimated to be 6.37 h (1.7 h). In 24 h 5.4% of the dose was excreted unchanged via urine and bile. Only a small fraction of the dose (0.53%) was recovered as glucuronide from urine and bile. Approximately 2% (0.74%) of the dose was excreted unchanged via bile. No other metabolites were detected. Plasma AUCO-24h was 3113 micrograms.h/l. The renal clearance of 27 ml/min (8.8 ml/min) was 3 times higher than the biliary clearance of 10 ml/min (2.4 ml/min). Azosemide is rapidly but incompletely absorbed and shows a longer half-life when compared with other loop diuretics. Enterohepatical circulation and first-pass effect seem to be less significant because low amount of azosemide is excreted via bile.

Adult↗
PubMed1992

[Primary intestinal tuberculosis in AIDS].

More than 50% of all HIV-infected patients have gastrointestinal symptoms like dysphagia, abdominal pain, diarrhea or intestinal bleeding. We describe an emergency situation with gross gastrointestinal bleeding in a twenty-seven year old drug addicted female. Colonoscopy and histological examination of the biopsies were the main diagnostic procedure to locate an extrapulmonary manifestation of a mycobacterium-tuberculosis-infection.

AIDS-Related Opportunistic Infections↗
PubMed1991

[Long-term prevention with H2 receptor antagonists. An effective concept for treating ulcer disease].

Chronic duodenal or gastric ulcer is a relapsing disease. Therefore, in many cases a long-term treatment strategy is required to prevent painful recurrences. As the recurrence rate as well as the rate of complications can be reduced to a high extent by a single nocturnal dosage, histamine-(H2)-receptor antagonists can be regarded as the drugs of the first choice. They have a very low rate of severe side-effects, especially those which were released more recently like ranitidine or famotidine. Frequently the healing of break-through-ulcers (which may occur under a long-term medication) can be achieved by doubling the dosage for a few weeks. Many reports recommend a maintenance treatment with H2-receptor antagonists for a period of two years. Only ulcer patients with frequent relapses should be treated either continuously for longer periods or surgical treatment (proximal gastric vagotomy, partial gastrectomy) should be considered. Complications which can not be managed conservatively or initial non-responders should also lead to surgical procedures.

Anti-Ulcer Agents↗
PubMed1991

[Non-cardiac thoracic pain. Diagnosis, differential diagnosis and therapy].

In about 50% of the cases, non-cardiac chest pain is due to hypomotile or hypermotile functional disorders of the esophagus. X-ray examination, endoscopy and manometry, possibly with provocation with edrophonium, confirm the diagnosis. Gastro-esophageal reflux is found in 40%, motility disorders in 20%, and an irritable esophagus in 40% of the cases. For diagnosis ex juvantibus, gastroprokinetic drugs or H2-blockers, nitro compounds and calcium antagonists may be useful.

Chest Pain↗
PubMed1991

Low-dose antacid therapy in the treatment of duodenal ulcer--a multicentre double-blind trial vs. misoprostol.

We conducted a 4-week double-blind randomized controlled multicentre trial to compare low-dose-antacid (AA) therapy (225 meq total neutralizing capacity per day) with therapy using the prostaglandin E1-analogue, misoprostol (MS) (400 micrograms bid), on ulcer healing and relief of symptoms in 100 outpatients with endoscopically proven duodenal ulcer (DU, 49 patients on AA, 51 patients on MS). Of the 100 patients enrolled in the study 96 could be evaluated; 49 received AA, 47 MS. Endoscopies were performed before treatment, 2 and 4 weeks after initiation of treatment. Healing rates of AA- and MS-treatment were 36.7% vs. 25.5% (2 weeks) and 79.6% vs. 74.4% (4 weeks) and did not differ as much as relief of pain during the daytime. Rates of relief of nighttime pain were significantly higher on AA-treatment after 2 weeks of treatment (81.1% vs. 48.6%; p less than 0.05), but not during the later course of treatment. Thus, it can be concluded that low-dose AA-treatment using an aluminum/magnesium hydroxide preparation in tablet form represents an effective and safe therapy for duodenal ulcer.

Adult↗
PubMed1991

Prokinetic drug treatment (cisapride) is as effective as H2-blocking agent (ranitidine) in the treatment of gastric ulcer.

A double-blind, randomized, parallel-group multicenter study was conducted in 120 patients with gastric ulcer to compare cisapride, 10 mg t.i.d., and ranitidine, 150 mg b.i.d., administered over 8 weeks. No significant differences between the results of the two treatments were found in terms of ulcer healing or symptomatic relief. Endoscopy showed that the incidence of medium-sized or large ulcers was reduced from 85% at the start to 11% and 4%, respectively, after 4 and 8 weeks in the ranitidine group, and from 98% to 15% and 4%, respectively, in the cisapride group. By week 8, the ulcer was healed in 89% of the ranitidine patients, and in 86% of the cisapride patients. Moderate to severe diurnal epigastric pain--the predominant symptom--was reported by about 80% of the patients in week 8, and by less than 15% from week 4 on. The response to nocturnal epigastric pain, epigastric pressure, sensation of fullness and other symptoms was similar. Except for gastrointestinal symptoms in the cisapride patients--nearly always indicative of enhanced bowel contractions--the occurrence of adverse effects was similar in the two groups. The improvement in gastrointestinal motility under cisapride, would appear to be as effective as suppression of acid secretion in the treatment of gastric ulcer disease.

Adult↗
PubMed1979

[Selective proximal vagotomy without drainage in uncomplicated duodenal ulcer. Technic and frequency of recurrence].

899 cases of slective promimal vagotomy were operated between 1974-1978 in the Surgical University Hospital Erlangen. The underlying disease was in all cases a chronical duodenal ulcer. The primary operative mortality was 0,6%. Intraopeatively measurements to control the sufficiency of the vagotomy Burge and Grassi proved to be necessary. We could verify by endoscopy a recurrence rate of 5,8-16,5% in the 1.-4. postoperative year. Only 58% of the recurrences could be found by x-ray investigations. 75-82% of the patients had a clinically perfect and good result. In patients with a proven recurrent ulcer there was nevertheless a good clinical result in 64%. Clinical results and complaints of the patients are therefore not sufficient as follow-up after selective proximal vagotomy and early detection of a recurrent ulcer. We believe, that one endoscopy per year is necessary.

Duodenal Ulcer↗
PubMed1979

[Long-term effect of calcium carbonate containing antacids on basally and peptone-stimulated hydrochloric acid secretion].

Basal and meal-stimulated gastric acid secretion was measured before and after a 3-week-period of regular consumption of a calcium carbonate-containing antacid with 6 therapeutic doses per day in normal healthy volunteers. Furthermore the effect of a single large dose of 2000 mg calcium ions was studied on meal-stimulated gastric acid secretion before and after this period. The results suggest that (1) even a large single dose of calcium ions seems to have no major effect on meal-stimulated gastric acid secretion and (2) chronic consumption of calcium carbonate containing antacids over a 3-week-period does not change basal- and meal-stimulated gastric acid secretion in healthy volunteers nor does it increase the response to 2 g calcium ions.

Adult↗
PubMed1979

[A prospective multi-centre study of the response of metastatic gastrointestinal tumours (author's transl)].

In a prospective, multi-centre, randomized study of 109 patients with metastatic gastro-intestinal adenocarcinomas the response rate, survival time and side-effects of two drug combinations, carmustin +5-fluorouracil and carmustin + ftorafur, were compared (same carmustin dosage in both groups). Response to the treatment was 32.7% in those receiving carmustin +5-fluorouracil, 26.3% in those on carmustin + ftorafur. This difference occurred among the 42 patients with gastric adenocarcinoma (33.3% compared with 25%), as well as in 11 with pancreatic adenocarcinoma, and in 56 with colorectal adenocarcinoma (32.1% and 28.6%). Median survival time for 5-fluorouracil + carmustin was 330 days, double that for ftorafur + carmustin (163 days). Bone-marrow toxicity (leukopenia, thrombopenia) was below 10% for both drug combinations. Alopecia occurred in only a few patients. Gastro-intestinal toxicity was common (20% and 18.5%, respectively), but there was no difference between the two groups. The somewhat lower effectiveness of ftorafur compared with 5-fluorouracil was probably due to the deliberately smaller dosage of the former.

Adenocarcinoma↗