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Biomedical subjects

W Rösch

Publications and source records attributed to W Rösch.

At least 217 records · Page 12Linked to original sources
PubMed1979

[Functional disorders of the esophagus. Diagnosis and therapy].

Functional disorders of the esophagus may be divided into alterations of the pharyngeal and upper esophageal sphincter motor function, malfunction of the tubular esophagus and disorders of the lower esophageal sphincter. Radiology, endoscopy and manometry are essential in the evaluation of the individual patient, in lower esophageal sphincter insufficiency with reflux disease acid clearance, reflux provocation test, acid perfusion and pH metry should be added. Conservative vs. operative therapy has to be critically evaluated. The diagnostic criteria of the most common functional disturbances like idiopathic diffuse esophageal spasm, achalasia and scleroderma are presented and therapeutic efforts discussed.

Antacids↗
PubMed1979

Endoscopic duct obstruction in chronic pancreatitis.

Ligation of Wirsung's duct or obstruction with a glue may be an alternative to pancreatectomy in patients with intractable pain due to chronic relapsing pancreatitis. In 10 patients obstruction of Wirsung's duct was performed via endoscopic retrograde instillation of an alcoholic aminoacid solution into the ductal system. All patients became free of symptoms within one week; no complications were seen. Long-term follow-up data, however, suggest that clinical improvement may be persistent in only about 50 per cent of the patients. Further data are necessary before endoscopic obstruction of Wirsung's duct can be recommended as a conservative method in the treatment of chronic pancreatitis.

Alcoholism↗
PubMed1979

[Early stomach cancer: new diagnostic and therapeutic aspects].

Gastroscopy is the diagnostic measure of choice in early recognition of gastric carcinoma, offering an accuracy rate of 96-99. However, this goal can only be achieved when biopsies are taken with forceps and snare from all circumscribed lesions which may hide a carcinoma. The common association with hyperplasiogenic polyps (15/86), adenoma and borderline lesion (7/86) and synchronous gastric carcinoma (8/86) request a subtle preoperative diagnosis if one does not perform gastrectomy in principle. Endoscopic resection (5/86) or local excision (6/86) should be debated in carcinomas located close to the cardia, and in high-risk patients. 5-year-survival rates of the "Erlangen early gastric cancer registry", are in accordance with the excellent results reported in the Japanese literature.

Adenoma↗
PubMed1979

Antibody-dependent cell-mediated cytotoxicity (ADCC) and cell-mediated cytotoxicity (CMC) to HBsAg-coated target cells in patients with hepatitis B and chronic hepatitis (CAH).

A new technique using HBsAg-coated Chang cells as target cells was developed in order to measure cell-mediated immune reactions to HBsAg. The specificity of cytotoxic reactions was tested in experiments using Chang cells conjugated with human serum albumin. Antibody-dependent cell-mediated cytotoxicity (ADCC) specific for the HBsAg-coated target cells was demonstrated up to dilutions of anti-HBsAg serum of 10,000 : 1, when lymphocytes from the peripheral blood of normal individuals were added to the target cells. Spontaneous cell-mediated cytotoxicity (CMC) to HBsAg-coated target cells was demonstrated for lymphocytes from patients with hepatitis B and from patients with chronic active hepatitis (CAH), but not for lymphocytes from healthy controls. The CMC of hepatitis B lymphocytes to HBsAg-coated target cells was inhibited in the presence of antiserum to HBsAg. In experiments using purified lymphocyte populations evidence is presented that the CMC is T-cell dependent. HLA-restriction of the CMC was not observed. The described cytotoxicity test system has the advantage that target cells conjugated with defined antigens are used and that relevant control target cells are available.

Antibody-Dependent Cell Cytotoxicity↗
PubMed1979

Increased duodenal alkali load associated with the interdigestive myoelectric complex.

In six healthy volunteers the interdigestive motor activity and the secretory pattern were recorded in the duodenum by open tip catheters and intraluminal titration, respectively. The duodenal part of the interdigestive myoelectric complex (IDMEC) was regularly associated with a significantly increased alkali load to the duodenum amounting to 2.4 +/- 0.4 mmol per IDMEC. Thus, the intestinal "housekeeper" function of the IDMEC may be brought about by a coupled action of propagated motility and flushing secretion.

Adult↗
PubMed1979

Effect of low dose secretin and caerulein on pure pancreatic bicarbonate secretion and plasma secretin in man.

In six healthy volunteers pure pancreatic juice was obtained by endoscopic cannulation of the main pancreatic duct. Following a 20-min basal period, secretin (0.03 CU/kg, h) was intravenously infused alone for 20 min and then with caerulein 15 ng/kg, h for further 20 min. From a basal level of 28 +/- 13 mu mol/5 min, secretin by itself significantly increased pancreatic bicarbonate to 182 +/- 24 mu mol/5 min. A further significant two-fold increase to 396 +/- 50 mu mol/5 min was observed during caerulein. The increment in plasma secretin of 2.1 +/- 0.3 pmol/l is comparable to the rise that may be observed post-prandially. It is concluded that secretin in combination with cholecystokinin may indeed play a physiological role in the regulation of duodenal pH.

Adult↗
PubMed1979

[Chronic pancreatitis: diagnostic value of endoscopic retrograde pancreaticography, of pancreatic sonography, and of secretin-pancreozymin test corrected for volume losses (author's transl)].

Endoscopic retrograde pancreaticography (ERP) and secretin-pancreozymin test corrected for losses (SP test) were performed in 153 patients suspected to have pancreatic disorders in order to evaluate diagnostic significance of these procedures. Pancreatic sonography was done in addition in 110 of these patients. If pancreatic excretion was normal, ERP results turned out to be normal in the same patients as well. SP test involves rather extensive laboratory work-up, but it does yield the most precise results as far as diagnosis of chronic pancreatitis is concerned. For this reason, and because of the possible complications caused by ERP, ERP should be applied only, when surgery is considered. Results of SP test and sonography coincided rather well. Therefore, sonography, not doing any harm to the patient, does have its place in the diagnosis of chronic pancreatitis.

Cholecystokinin↗
PubMed1978

[Results of treatment in early carcinoma of the stomach].

From 1961 to 1975, 53 patients were operated on for early carcinoma of the stomach, 24 or the total of 57 cancer sites being limited to the mucosa, 33 having already infiltrated into the submucosa. Macroscopically, most of them were ulcerative carcinoma, while histologically the intestinal type predominated. The cumulative five-year survival rate (excluding hospital deaths) was 86.5%, while after "typical" carcinoma resection by the Billroth II procedure with removal of the greater and lesser omentum it was 100% for mucosal and 93% for submucosal carcinoma.

Adult↗
PubMed1978

[Polyneuropathy, adrenal insufficiency and diarrhea of unknown origin].

Clinico-pathological conference concerning a syndrome, characterized by considerable diagnostic problems. Polyneuropathy, adrenocortical insufficiency and diarrhea without typical changes in laboratory or functional data should always lead to the suspicion of primary amyloidosis. This diagnosis could be confirmed in the discussed case report. Its clinical relevance in regard to the type of spreading--perireticular or pericollagenous--is discussed, methods for identification are mentioned.

Adrenal Cortex Diseases↗
PubMed1978

[Angiodysplasia of the gut as cause of massive gastrointestinal bleeding (author's transl)].

Angiodysplasia of the colon with preferential localisation in the region the ileocoecal valve is not infrequently the cause of massive gastrointestinal bleeding. The diagnostic problems of this disease are illustrated by seven cases. Contrary to angiography, coloscopy, which may have to be done as an emergency procedure, frequently does not allow localisation of the haemorrhage. Vascular malformations can be demonstrated by arteriography even in the asymptomatic interval. They frequently escape macroscopic identification even in the resected specimen due to their small size and their localisation in the submucosa. The diagnosis can be established histologically by serial sections with vascular filling if necessary. The treatment of choice is resection of the affected part of the gut. In cases of decreased operability endoscopic laser coagulation can be indicated.

Aged↗
PubMed1978

[High risk groups for gastrointestinal carcinoma].

High-risk groups for gastrointestinal carcinoma are heterogenic in regard to etiopathology; familial predisposition and genetic defects (familial adenomatosis coli, tylosis palmaris et plantaris, Gardner syndrome, Peutz-Jeghers syndrome), occupational factors (asbestor exposure), surgical intervention (resected stomach, ureterosigmoidostomy), long lasting passage obstruction (oesophagus) or chronic inflammatory alteration of the mucosa (pernicious anemia, ulcerative colitis, Crohn's disease, glutenenteropathy). Although high-risk groups account only for about 5 per cent of all carcinomas, consequent follow-up examinations of these small collectives offer early diagnosis of carcinoma at a curable stage.

Achlorhydria↗
PubMed1978

Synopsis of endoscopic and related morphological findings in Whipple's disease.

Whipple's disease is characterized by typical endoscopic lesions in the duodenal wall. They consist of a thickened and inflamed mucosa with yellowish-white spots, in part solitary, in part confluent. Petechial hemorrhages mark the high mucosal vulnerability. Clumsy and dilated villi with ectatic lymph vessels and PAS-positive macrophages are the corresponding histologic feature. In the ultrastructure numerous rod-shaped micro-organisms are evident. Following treatment with tetracycline the mucosal surface normalizes rapidly, the bacteria disappear, whereas other histologic changes remain over a longer period of time.

Bacteria↗