Search PubMed⌕ Search

Biomedical subjects

D Wurbs

Publications and source records attributed to D Wurbs.

At least 37 records · Page 2Linked to original sources
PubMed1981

[Endoscopic determination of the size of gastrointestinal ulcers (author's transl)].

A new method based on computer-assisted semi-automatic equipment for stereological analysis has been developed to measure ulcer size endoscopically. The main component is a graphic measuring table connected with a computer which is itself linked to a television monitor. The endoscopic picture is transmitted to the television monitor and the ulcer area is measured directly on the monitor using electronic overlay markers. The trace of the measuring markers remains visible on the monitor so that every lesion demonstrated is accurately outlined. The computer calculates the ulcer area by relating it to a known endoscopically inserted reference area. Numerous measurements from various distances, various angles of view and with variable reference area sizes showed the error to be 4.2 +/- 0.5%. Measurements by six different investigators showed variations of 2.9 +/- 1.2%. These results document the reliability of endoscopic planimetrics of gastrointestinal ulcers.

Anthropometry↗
PubMed1981

[Bacterial elimination and antibiotic concentration in the gall-bladder during biliary tract infections treated with mezlocillin (author's transl)].

A transpapillary indwelling catheter was placed in 15 patients with choledocholithiasis and threatened occlusion by stone. Ten of the 15 patients had marked biliary stasis, four had signs of acute cholangitis. In all patients E. coli was present in the gall-bladder in a concentration of greater than or equal to 10(5)/ml when the catheter was first inserted. The bacteria were sensitive to mezlocillin, at a minimal inhibitor concentration between 1.5 and 16 micrograms/ml. All patients received mezlocillin, 5 g twice daily, in a short-term infusion. Immediately before and regularly thereafter bile samples were taken to measure antibiotic concentration and bacterial counts (by membrane filtration). Mezlocillin was excreted in the bile in very high concentrations in patients without biliary stasis. But while the concentrations were markedly lower in those with stasis, they were still 10 to 100 times the minimum inhibitory concentration of mezlocillin against the appropriate strains. In keeping with the high mezlocillin concentration, bacterial counts fell much more quickly in the patients without stasis than in those with alkaline phosphatase concentration above 250 U/l. These differences were even more marked after two or three days. Bacterial elimination from bile was complete in two of three patients with normal alkaline phosphatase activity, but in only one of five in whom it was elevated.

Aged↗
PubMed1981

A new method for the endoscopic determination of gastrointestinal ulcer area.

Current endoscopic measurements of gastrointestinal ulcer area using forceps or graduated probes are associated with a high degree of inaccuracy. Based on a computer-assisted, semiautomatic device for stereological analyses, we have developed a new method for the endoscopic determination of ulcer size. The basic elements are a graphical measuring tablet coupled with a computer, the later being connected to TV-monitor. The endoscopic picture is transmitted to the TV-monitor and the ulcerated area is measured directly on the TV-monitor by means of an electronic overlay marker. The trace of the marker remains visible on the screen so that any circumscribed lesion can be labelled exactly. From the relation of a known, endoscopically introduced reference area to the circumscribed ulcerated area, the latter is calculated by the computer. Multiple measurements obtained at different distances, and visual angles, and with different reference areas, revealed an error of 4.2 +/- 0.5%. Inter-observer variation among 6 different examiners was 2.9 +/- 1.2%. These results document the reliability of endoscopic planimetry of gastrointestinal ulcers.

Computers↗
PubMed1981

Alternating treatment of common bile duct stones with a modified glyceryl-1-monooctanoate preparation and a bile acid-EDTA solution by nasobiliary tube.

Twenty patients with bile duct stones were treated via an indwelling nasobiliary tube with a modified Capmul 8210 preparation (GMOC) and alternating with a bile salt-EDTA (BA-EDTA) solution for an average of 12 days. In vitro the dissolution capacity of GMOC and BA-EDTA for cholesterol stones was higher than that of Capmul 8210. The nasobiliary tube was tolerated well for a maximum of 84 days; this renders us independent of the T-tube. The therapeutic success rate of GMOC was 64%, even though we treated mostly old and large concrements. Side effects occurred markedly less than with Capmul 8210. In patients with acute cholecystitis or cholangitis the clinical course improved under therapy, and there was no deterioration of a chronic condition.

Aged↗
PubMed1981

[Nonocclusive mesenteric ischemia (author's transl)].

This report intends to emphasize the importance of selective angiography in nonocclusive mesenteric ischemia (NMI). In a 67-year-old male with abdominal pain and weight loss the diagnosis of NMI was made angiographically after enteroclysis had shown extensive ulcerative jejunitis. In this condition, where constriction and obliteration of vasa recta of the superior mesenteric artery are present, operation is contraindicated. Current status of still incomplete understanding of the disease is discussed.

Aged↗
PubMed1980

Descending sphincterotomy of the papilla of Vater through a choledochoduodenostomy under endoscopic view. Another variant of endoscopic papillotomy (EPT).

Endoscopic papillotomy required deep cannulation of the papilla of Vater. But retrograde placing of the papillotome in the distal common bile duct is not always possible. Occasionally conditions permitting a descending antegrade cannilation of the papilla are found. An existing choledochoduodenostomy can be used as access for such a cannulation from above. A papillotome, type Erlangen, introduced into the papilla from above, spontaneously adopts the correct cutting direction. With regard to its length the incision has, however, to be monitored endoscopically. Also, undesired additional burns in the duodenum only can be avoided by endoscopic control. This may require the use of a second instrument. The technique described above was successfully applied as another variant of descending papillotomy.

Aged↗
PubMed1980

Experiences with the long standing nasobiliary tube in biliary diseases.

Specially designed longstanding nasobiliary tubes allow to reflect upon some well established therapeutic rules. The safe, decompressing effect of the tube leads to prompt relief of obstructive suppurative cholangitis. Therefore emergency of laparotomy can be avoided in high risk patients. Large common bile duct stones until now have required a large papillotomy with increased frequency of complications. The attempt to dissolve those stones with Capmul is justified on an account of a 50% success rate. Either a very small EPT or even non is necessary in order to insert the tube.

Acute Disease↗
PubMed1980

[Resolution of cholesterol-gallstone with a modified Capmul 8210-emulsion and with an EDTA solution (author's transl)].

Cholesterol stones in the bile duct may be resolved by applying Capmul 8210 (Cholesterol-caprylic acid ester) by way of T-drain or through a gastro-biliary tube. Results of in vitro experiments and a case reported do show, that an alternating irrigation with a specially prepared solution of glycerooctonate with bile salt-EDTA-solution will yield better results than Capmul 8210 alone. The advantage of this alternating therapy results from the fact, that calcium bilirubinate may be resolved in addition to the other components of the gallstones, and that side effects are rarer and less disturbing than side effects caused by Capmul 8210.

Anticholesteremic Agents↗
PubMed1980

[Longterm controls after endoscopic papillotomy [EPT] (author's transl)].

In 117 patients who have undergone endoscopic papillotomy (EPT) long term controls have been done. 51 were controlled in the hospital and 66 did answer a questionnaire. The mean time interval to the EPT was mean = 21.6 months. Nine out of every ten patients had no complaints. One third had minimal changes of laboratory dates, which can easily be explained by second diseases. With nearly no exception there was a large orifice to the common bile duct at the upper brim of the papilla. There was no bilioduodenal pressure gradient in 75%. Duodenobiliary reflux could be demonstrated in 25% and aerobilia in 65%. Although there was a massive bacteriobilia in all cases, no signs of cholangitis could be found in any patient. As a result, no unfavourable effects of the EPT became obvious during this follow-up study.

Aged↗
PubMed1979

[Therapeutic endoscopy in the gastrointestinal tract].

In selected chapters of the therapeutic endoscopy we tried to represent secure knowledge, actual tendencies and partly future prognoses. Hereby completeness cannot be expected. However, it became clear that numerous physical principles became useful for the therapy with the endoscope. Chemical techniques, such as the litholysis of gall-stones are only at present used in our field. With all scepticism against the own field of interest one may say that the operative therapeutic endoscopy, as it is seen at the instance of the classification of polyps, has led to an improvement of the diagnostics, Its advantages in the therapeutic field are based on the fact that it substitutes larger operations. In the polypectomy- the intervention, avoiding laparotomy and colotomy, is reduced on the minimum given by the size of the polyp. The risk of endoscopic operations is small, compared with the alternative surgical interventions. Shortening of the duration of the disease and hospitalisation leads to lower expenses. Methods, such as the endoscopic haemostypsis or the obliteration of the pancreatic duct, need further detailed examinations. There is no doubt that the modern endoscopy has a strong technical fascination for many young physicians. It gets the greatest value in the hands of a clinically experienced physician.

Cholelithiasis↗
PubMed1979

[A comparison of percutaneous transhepatic cholangiography and endoscopic retrograde cholangiopancreatography (author's transl)].

Results of percutaneous transhepatic cholangiography (PTC) with the Chiba needle were compared with those obtained by endoscopic retrograde cholangiopancreatography (ERCP). PTC was used in 102 cases, most often after ERCP had been inconclusive or had failed. Overall success rate of PTC was 79%. Contrast medium could be injected in only 66% of cases with normal-sized bile passages, but in 98% of those with enlarged passages. The most frequent side effect was temporary pain in the right upper abdominal quadrant. One patient had transitory severe peritoneal irritation with shock. Emergency operation was never required. PTC is technically simpler, takes less time and causes less stress to the patient, but it is less informative than ERCP. If, therefore, both methods are mastered technically, ERCP should be employed first. If it fails to provide the diagnosis, PTC can be performed at once. Biliojejunal anastomoses and pancreatic pseudocysts are absolute indications for the primary use of PTC to investigate the cause of biliary stasis. On the other hand, allergies to iodine or contrast medium and disorders of coagulation are absolute indications for ERCP.

Adult↗