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Biomedical subjects

B Limberg

Publications and source records attributed to B Limberg.

At least 37 records · Page 2Linked to original sources
PubMed1992

Diagnosis and staging of colonic tumors by conventional abdominal sonography as compared with hydrocolonic sonography.

BACKGROUND: Ultrasonic examination has become increasingly important in the diagnosis of diseases of the gastrointestinal tract. In neoplastic diseases of the large intestine, however, the diagnostic value of conventional transabdominal sonography is limited. The purpose of this investigation was to determine whether the evaluation and staging of colonic tumors would be improved by the retrograde instillation of water into the colon in a procedure called hydrocolonic sonography. METHODS: Three hundred patients were examined in a prospective study in which both conventional transabdominal sonography and transabdominal hydrocolonic sonography were performed before the diagnosis was verified by colonoscopy. The indication for the examinations was abdominal pain, diarrhea, weight loss, or the presence of occult blood in a stool specimen. RESULTS: With the instillation of water into the colon, it was possible to display the colon sonographically from the rectosigmoid transition to the cecum in 97 percent of the patients examined. In addition to permitting the evaluation of the colonic lumen, the procedure allowed the five layers of the colonic wall and the connective tissue surrounding the colon to be examined in detail. Only 9 of 29 carcinomas were diagnosed by conventional abdominal sonography (31 percent), whereas hydrocolonic sonography permitted the diagnosis of 28 (97 percent). No polyps could be detected by conventional abdominal sonography, whereas hydrocolonic sonography permitted the diagnosis of 38 of 42 polyps greater than or equal to 7 mm (91 percent) and 3 of 12 polyps less than 7 mm (25 percent). In addition, detailed evaluation of the structure of the bowel wall with hydrocolonic sonography permitted a more precise staging of colonic tumors. CONCLUSIONS: Hydrocolonic sonography, a new diagnostic procedure, can facilitate the diagnosis and staging of colonic tumors.

Abdomen↗
PubMed1991

[The duplex sonographic diagnosis of portal hypertension in liver cirrhosis. The effect of a standardized test meal on portal hemodynamics].

The effect of a standardized test meal on portal haemodynamics was measured by duplex ultrasonography in healthy subjects (12 men and 13 women; mean age 43 +/- 9 years) and patients with liver cirrhosis (14 men and 11 women; mean age 55 +/- 10 years). Maximal flow velocity, vessel diameter and flow volume were measured in the portal vein and superior mesenteric artery before the test meal and 15, 30 and 45 min thereafter. After a 12-hour fasting period maximal flow velocity in the portal vein was significantly lower in the cirrhosis patients than the normal subjects (P less than 0.05), but the individual values clearly overlapped. 30 min after the test meal flow velocity in the portal vein rose by 22%, flow volume by 29% in the cirrhosis patients, but by 76% and 131%, respectively, in the normal controls (P less than 0.01). Vessel diameter remained constant in the patients, but increased significantly in the controls (P less than 0.05). There was no overlapping of values between the two groups. The increase in flow velocity in the superior mesenteric artery was nearly the same in both groups. It is concluded that, after a test meal the haemodynamic differences between normal subjects and cirrhosis patients becomes quite marked and thus can provide a more exact diagnosis of portal hypertension by duplex ultrasonography.

Adult↗
PubMed1991

[Sonography in Crohn disease--the conclusions of an experts' group].

Sonography is adding a new dimension to diagnosis of Crohn's disease: the analysis of the transmural and peri-intestinal manifestations of the chronic inflammation. Distortions in the structure of intestinal wall are recognizable, the impact on transport of intestinal content can be judged, penetration of inflammation into the bowel surrounding as fistula, abscess, mesenteriitis und peritonitis is safely seen. Differential diagnosis on a strictly sonographic basis is difficult. The paper represents the results of an expert meeting held at the University of Frankfurt/M.

Crohn Disease↗
PubMed1990

Diagnosis of large bowel tumours by colonic sonography.

To investigate whether the retrograde instillation of fluid into the colon would improve the diagnostic value of ultrasonography in assessing neoplastic diseases of the large intestine 220 patients were examined by colonic sonography before colonoscopy. Polyps larger than 7 mm diameter could be identified in 91% of cases, whereas polyps smaller than 7 mm could not always be visualised. The sensitivity of the technique in the detection of colonic carcinomas was 94% and the specificity was 100%. The results suggest that colonic sonography is an effective diagnostic procedure that may find application as a screening procedure for neoplastic diseases of the colon.

Carcinoma↗
PubMed1990

[Diagnosis of tumors of the large intestine by colonic ultrasound].

Retrograde instillation of liquid into the colon allows a specific, percutaneous sonographic examination of the colon to be performed. As part of a prospective study of the diagnosis of colonic tumors in 260 patients, this form of colon sonography was examined together with colonoscopy. Sonographically, colonic polyps and carcinomas of the colon manifested as echogenic, parietal masses. Using colonic sonography, it was possible to identify 96% of the carcinomas that had been diagnosed colonoscopically. The sonographic diagnosis of polyps was insufficient if they were smaller than 6 mm: if they were larger than 7 mm, however, diagnostic sensitivity was 91%. The results of this study show that colon sonography is a new, sensitive method in the diagnosis of colonic tumors.

Cecal Neoplasms↗
PubMed1990

[Colon sonography--a new method in the diagnosis of Crohn disease and ulcerative colitis].

The entire length of the colon, starting at the recto-sigmoid junction and ending at the cecum, can be visualized sonographically following retrograde water instillation into the colon. Using this method it is possible to evaluate in detail the lumen, the intestinal wall and the surrounding connective tissue. Severe active colonic Crohn's disease and ulcerative colitis can be detected by diagnostic sonography of the colon with a sensitivity of 91% and 89% respectively. Crohn's disease can be differentiated from ulcerative colitis in 86% of the cases by means of colonic sonography. Transabdominal sonography of the fluid-filled colon is a new diagnostic procedure especially in children with Crohn's disease and ulcerative colitis.

Adult↗
PubMed1989

Diagnosis of acute ulcerative colitis and colonic Crohn's disease by colonic sonography.

By instilling water into the large intestine, sonographic visualization of the whole length of the colon from the rectosigmoid to the cecum can be achieved. Furthermore, using this method, it is possible to evaluate the lumen, the intestinal wall, and the surrounding connective tissue in detail. In our study, severe, active colonic Crohn's disease and ulcerative colitis could be detected by diagnostic sonography of the colon with a sensitivity of 91% and 89%, respectively. Pathological changes were subsequently confirmed by colonoscopy. Differing echo patterns made differentiation of these two diseases possible. Our results thus show that colonic sonography is a diagnostic procedure that promises to greatly facilitate the evaluation and differentiation of inflammatory large bowel diseases.

Adult↗
PubMed1987

[Differential diagnosis of acute inflammatory colon diseases by colonic sonography].

Colon sonography enables imaging of the colon from the beginning of the rectosigmoid transition up to the cecum. Colon sonographic investigations in 29 patients (normal findings n = 15, ulcerative colitis n = 6, Crohn's disease n = 8) with a finding verified by coloscopy and biopsy show that acute ulcerative colitis and florid Crohn's disease lead to different sonographic alterations. Formation of haustra can no longer be detected in the two diseases. In Crohn's disease, the typical sonographically discernible wall layering has been abolished, and the wall is markedly thickened. In contrast to this, the wall layering is preserved in acute ulcerative colitis and the wall is only moderately thickened. The results show that differential diagnosis of acute inflammatory diseases of the large intestine is possible using colon sonography.

Adult↗
PubMed1987

Diagnosis of inflammatory and neoplastic colonic disease by sonography.

By instilling fluid into the large intestine, it is possible to demonstrate the entire colon starting at the recto-sigmoidal boundary and ending at the cecum. Aside from demonstrating the intestinal lumen, a high resolving transducer will also allow detailed evaluation of the intestinal wall and its surrounding tissue. Examination of 61 patients with colonoscopic-verified diagnoses showed that polyps as well as colon cancer can be diagnosed by colonic sonography. Aside from such localized changes, colonic sonography can also demonstrate typical changes of Crohn's disease as well as the extent of colonic inflammatory involvement. Colonic sonography is a diagnostic procedure that permits specific statements regarding diseases involving the large intestine.

Adult↗
PubMed1987

Histologic differential diagnosis of focal liver lesions by ultrasonically guided fine needle biopsy.

Ultrasonically guided fine needle biopsies were carried out in 84 patients with focal liver lesions and were subsequently evaluated histologically. A correct diagnosis of malignancy was made in 46 of 52 patients with proven hepatic malignancy, showing an overall accuracy of 93%. The specificity of the procedure was 100%. Such histological examination not only enables the differentiation between primary and secondary hepatic malignancy; it has the additional advantage of making a more precise tumour description and at the same time it pinpoints the primary site of the tumour.

Biopsy, Needle↗
PubMed1986

[Diagnosis of inflammatory and tumorous changes of the large intestine using colonic sonography].

By water instillation into the large intestine, sonographic visualization of the whole length of the colon from the recto-sigmoid to the caecum can be achieved. Detailed evaluation of the lumen, the wall and the surrounding connective tissue may be carried out. Diagnostic sonography of the colon in 41 patients with pathological changes confirmed by colonoscopy showed that colonic polyps and carcinomas can be detected by this method. In Crohn's disease, typical changes can be seen, which allow the degree of inflammatory infiltration to be assessed. Thus, sonography of the colon is a diagnostic procedure which gives discriminating evidence in diseases of the large intestine.

Adult↗
PubMed1985

Diagnostic accuracy of computerized B-scan texture analysis and conventional ultrasonography in diffuse parenchymal and malignant liver disease.

The use of a diagnostic system for ultrasonic liver tissue characterization based on computerized B-mode image analysis is clinically tested and compared with the results of conventional realtime and static grey scale liver ultrasound as independently assessed by three experienced observers. The diagnostic classes, normal, diffuse parenchymal and malignant disease, are clearly differentiated by computerized image analysis which is superior to subjective evaluation of liver echograms. Computerized analysis also renders a reliable and clinically useful diagnostic subclassification of diffuse parenchymal disease into echopattern changes prevalent in chronic hepatitis, cirrhosis/fibrosis, fatty infiltration and a mixed state of cirrhosis/fibrosis with fatty infiltration which cannot be achieved by conventional liver ultrasound.

Computers↗
PubMed1984

[Gray-level histogram analysis in the sonographic diagnosis of diffuse parenchymal liver disease].

Increased echogenicity is one of the major diagnostic criteria for the subjective evaluation of liver echograms. In our approach to ultrasonic tissue characterisation by B-scan image analysis echogenicity is expressed by parameters deriving from the grey-level histogram. In this study the grey level histograms of a group of normals and patients with diffuse parenchymal liver disease are analysed. When employing the two parameters mean grey level (G) and standard deviation of grey levels (SG) the diagnostic accuracy was 90% (specificity 95%, sensitivity 85%). For subjective evaluation the liver echograms of a randomly selected sub-group of normals and patients were blindly evaluated by three observers who positively correlated the finding of increased echogenicity with the diagnosis of a pathological liver echogram. As demonstrated by our results the two-parameter analysis of the grey-level histogram leads to a quantification of the subjective diagnostic criterion of echogenicity, thus providing useful information for image interpretation.

Color↗
PubMed1984

Correction of altered plasma amino acid pattern in cirrhosis of the liver by somatostatin.

The purpose of our study was to evaluate the effect of somatostatin (500 microgram/h intravenously) upon insulin, c-peptide, glucagon and plasma amino acids concentrations in patients with and without cirrhosis of the liver. The typical plasma amino acid pattern in cirrhosis is characterised by increased concentrations of the aromatic amino acids and decreased concentrations of the branched chain amino acids and of alanine and glycine. After administration of somatostatin insulin, c-peptide and glucagon concentrations decreased and those of the branched chain amino acids in both groups increased; in addition in patients with cirrhosis the plasma concentrations of threonine, serine, glycine, alanine, lysine, and arginine increased also. Infusion of somatostatin plus insulin in patients with cirrhosis succeeded in preventing the increase in the branched chain amino acid concentrations, while the infusion of somatostatin plus glucagon decreased threonine, serine, glycine, alinine, phenylalanine, tyrosine, lysine and arginine concentrations. It is therefore suggested that the effect of somatostatin on the plasma amino acids may be because of the reduction of insulin and glucagon concentrations; however, other effects of somatostatin cannot be excluded at present.

Amino Acids↗
PubMed1983

Influence of a continuous intragastric and intravenous infusion of somatostatin on stimulated gastric secretion.

Our study demonstrated that somatostatin given i.v. in a dose of 250 micrograms/kg per hour significantly inhibited pentagastrin-stimulated gastric secretion, whereas continuous intragastric administration of somatostatin (up to 3 mg/h) failed to do so. We concluded, therefore, that luminally secreted somatostatin plays only a minor role in the regulation of gastric secretion.

Administration, Oral↗
PubMed1983

Beneficial effect of somatostatin on galactosamine induced liver injury.

The purpose of our investigation was to study the effect of somatostatin on acute experimental liver injury induced in rats by galactosamine (1.2 g/100 g body wt.). Somatostatin (125 micrograms/100 g body wt.) was administered subcutaneously in a protamine sulphate/ZnCl2 suspension either 2 h prior to the injection of galactosamine or 2 h and again 12 h following the injection. Serum transaminases (GOT, GPT) and serum concentrations of triiodothyronine and thyroxine were determined 28 h after the injection of galactosamine. Histology of the liver was performed by light microscopy. Our results showed that the administration of somatostatin significantly (P less than 0.02) reduced the elevation of GOT and GPT activity and diminished the degree of necrosis, and that although the administration of dibutyryl-cAMP (5 mg/100 g body wt.) intensified galactosamine induced liver injury, this effect of dibutyryl-cAMP could be completely prevented by somatostatin treatment. There was no difference in the serum concentrations of triiodothyronine and thyroxine in controls as compared to galactosamine and galactosamine plus somatostatin treated rats. At present the mechanism of this cytoprotection by somatostatin is unknown.

Alanine Transaminase↗