[Proposals for the explanation of diagnostic procedures in gastroenterology].
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Biopsy↗
Biomedical subjects
C Metzner
Publications and source records attributed to C Metzner.
[Does abdoman cause ileus?].
On account of its favourable pharmacological properties Abdoman has proved in the treatment of patients with uncomplicated duodenal ulcer. On the basis of its pronounced motility inhibiting effect on the gastrointestinal canal it may be additionally used for the treatment of diarrhoea. It is reported on 5 patients in which under Abdoman therapy a paralytic ileus developed as severe complication, so that it must be warned of an uncontrolled prescription of abdoman concerning this indication. Abdoman should be used above all in juvenile patients, in which case particular attention must be paid to obstipation as most frequent side-effect.
Aged↗
[Physical capacity of patients with liver diseases as well as its significance for therapy and evaluation].
In 50 patients with different liver diseases (20 with subsided viral hepatitis and 30 with degenerative liver damages) the serum enzyme course of SGOT, SGPT, LDH and CPK was investigated after ergometer load. The enzymes were estimated before as well as 1/2, 2, 4, 24, and 48 hours after load. 48 hours after load additionally the liver biopsy after Menghini was carried out. According to the histological findings the 20 patients with viral hepatitis were subdivided into 13 with still active and 7 with residual hepatitis as well as the 30 patients with degenerative liver damages into 15 with toxical hepatosis, 6 with fatty degeneration of the liver cells and 9 with signs of metabolic activation. Since the significant increases of enzymes could not be proved in any of the fours enzymes 1/2 to 48 hours after load we are of the opinion that the liver, independent on the kind of the lesion, better tolerates physical work. Moreover, it seems that load investigations under ergometry with estimation of the course of the serum enzymes are unsuited for the judgment of the degree of activity and the degree of cure of liver diseases, respectively.
Adult↗
[Incidence of toxic liver lesions due to Gravistat].
In 200 women who on the average 5.6 years took ovosiston and/or non-ovlon, and in 40 women who during the last three months had not taken an oral contraceptive we determined the GOT, the GPT, and LP-X and the cholesterol in the serum before and after a three weeks intake of gravistat. After a three weeks intake of gravistat of the two groups ca. one fourth showed pathological transaminases. 30 women with pathological transaminases and/or positive LP-X were hepatologically investigated including liver biopsy after an on an average 7.3 weeks exposition of gravistat. In ca. one third of the cases histologically provable changes of the liver (toxic hepatosis, fatty liver, infectious hepatitis) and in ca. two thirds of the cases the picture of the metabolic activation were found. Morphologically no signs of an intrahepatic cholostasis could be proved, so that it does not seem to be the leading parameter of the toxic liver damage.
Chemical and Drug Induced Liver Injury↗
[Toxic hepatoses due to Gravistat].
With the help of 5 cases with toxic hepatosis by administration of Gravistat the problems concerning ovulation inhibitor and toxic hepatosis were explained. The clinical, paraclinical and histological findings may be pronounced differently. Anamnestically in prescribing ovulation inhibitors particularly a jaundice during pregnancy or a pronounced pruritus in the 3rd trimester of the pregnancy must be taken into consideration. Toxic liver damage may appear not only when the ovulation inhibitor is given the first time, but also after changing it. For this reasons idiopathic jaundice during pregnancy and condition after toxic hepatosis by ovulation inhibitor in every case must be regarded as contraindications for the application of oral contraceptives. In order to establish subclinical courses a control of transaminases in the first three cycles of using the remedies is to be demanded.
Adult↗
[Steatosis of the liver cells--subclinical liver damage or more?].
The basis of the results are histological investigations of the preparations of liver biopsy of 134 donors who were evident in the SGPT-screening and of 100 patients with viral hepatitis after normalisation of the clinical and the laboratory-chemical findings. The liver casts were got by means of Menghini's method. In patients with hepatitis we found in 43% and in donors in 44% a small-droplet to medium size droplet fatty change in the liver cells. A large-droplet fatty change in the liver cells occurred in the patients with hepatitis only in 2% of the cases, in the donors, however, in 25%. Factors which favour the fatty change in the liver cells, such as adiposis, alcohol and prednisone therapy, were excluded. Our results increase the suspicion that in one part of the clinically healthy donors who are evident in the SGPT-screening we have to do with persons who are in the healing phase of a viral hepatitis with abortive course. Therefore, these persons should be excluded from blood donation. Donors and patients with the findings of a large-droplet fatty change in the liver cells must be investigated systemically. Blood donors with the findings of a fatty liver may remain in the team of donors.
Adolescent↗
[The significance of histological findings for the final clinical evaluation in acute viral hepatitis].
Clinical and morphological findings of 406 patients who fell ill from a virus hepatitis were established according to the data and statistically evaluated to find relations between clinical, serochemical and histological criteria. The results were tested statistically. Clinical and paraclinical findings at the end of the hospital treatment give no evidence concerning the histological degree of cure of the acute virus hepatitis. In normalised clinical and serochemical findings we could morphologically prove an acute hepatitis still in 27.4%. Anamnestic data and severity of the clinical course have no relation to the histological diagnosis at the end of the hospital treatment with clinical and serochemical recovery. Therefore, at the end of the hospital treatment we recommend the liver biopsy as final examination. The most favourable date of the liver biopsy would, however, be between the 6th and 12th week after discharge.
Alanine Transaminase↗