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Biomedical subjects

E C Foerster

Publications and source records attributed to E C Foerster.

At least 37 records · Page 2Linked to original sources
PubMed1993

Ex vivo examination of the pancreas by intraductal ultrasonography (IDUS)

Pancreas specimens from humans (seven normal autopsy specimens, one surgical resection specimen containing a 15 mm microcystic adenoma in the pancreatic head) were examined by intraductal ultrasonography using flexible, high-resolution ultrasonic catheters (20 MHz, 4.8 and 6.0 French diameter). The catheters were easily inserted into the pancreatic duct in all specimens. The ultrasonographic tissue pattern could be correlated with the histological findings in tissue cross-sections at defined positions. A high degree of resolution was achieved in the differentiation of blood vessels, duct system elements, fibrotic tissue, fatty tissue and pancreatic tissue with a varying fat content. At an average distance of 5.5 mm, structures as small as 0.1 mm could be discriminated. No evidence of ductal trauma due to insertion of the catheters was found either on subsequent radiographic studies or on histologic examination. Clinical studies using this probe during ERCP are necessary to clarify whether intraductal ultrasonography could contribute to the diagnosis of small pancreatic lesions and to the differentiation of indeterminate ductal stenoses.

Adenoma↗
PubMed1992

[Clinical significance of endoscopy of the pancreatic duct].

In the context of ERP, early pancreatoscopies--which had an external diameter of 2.3 mm or 1.7 mm--carried many disadvantages. Technical inaccessibility due to previous papillotomy and the rigidity and fragility of the endoscope limited inspection of the pancreatic duct. In the following years, this method was therefore not generally propagated. The recent development of highly flexible fine endoscopes with an external diameter of 0.5 mm, endoscopic inspection of a normal-caliber pancreatic duct is now possible without papillotomy. This new fully sterilizable miniscope which we present here is capable of inspecting normal pancreatic ducts without papillotomy in 90% of cases. Especially tumour stenoses of the pancreatic duct can be well documented using this miniscope.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1991

Bridging of benign choledochal stenoses by endoscopic retrograde implantation of mesh stents.

A prospective study of a new stent for bridging choledochal stenoses was performed in seven patients (5 females, 2 males, age range 49-80 years) with benign bile duct stenosis or bilioduodenal fistula in whom conventional bougienage (3 patients) and/or month-long implantation of plastic prostheses (7 patients) failed because of reocclusion. The self-expanding mesh stents (Wallstent) were implanted by duodenoscopy in six patients. In one patient with a B-II stomach, the stent could only be inserted by the percutaneous transhepatic route. All prostheses were inserted endoscopically without complications. At follow-up after an average of eight months prosthesis-related complications were found in only one patient; there was no case of prosthesis occlusion. One patient with a bilioduodenal fistula of unknown origin developed fever and sepsis three days after implantation and subsequently a liver abscess which resolved on repeated drainage and antibiotic therapy. Although definitive interpretation of the results requires a longer follow-up period, on the basis of the present data endoscopic reconstructive splinting of benign choledochal stenosis would appear to be a promising technique.

Aged↗
PubMed1990

[Encephalitis in Legionella bozemanii pneumonia].

A 44-year-old man, a known alcoholic and heavy smoker, was hospitalized with high fever and respiratory failure which a few hours later required intubation and artificial ventilation, although the chest x-ray had been unremarkable. Later serial chest x-ray films showed intrapulmonary infiltrations, while Legionella Bozemanii was demonstrated by direct immunofluorescence. Cranial computed tomography was unremarkable, despite the onset of tetraparesis and a severe midbrain syndrome. Cerebrospinal fluid contained merely mild lymphocytic pleocytosis. However, magnetic resonance imaging revealed symmetrical demyelinization foci in the brainstem as a sign of encephalitis. The neurological deficits regressed almost completely after several weeks of antibiotic treatment and rehabilitation measures over several months.

Adult↗
PubMed1990

[The retrograde endoscopically implantable, self-expanding endoprosthesis (stent) in malignant choledochal stenoses].

Self-expanding, wire-mesh stents, 10 mm in diameter, were implanted retrogradely through the papilla of Vater via an endoscopically introduced catheter system in 14 patients (9 females, 5 males, mean age 70.2 [44-85] years) with stenosis of the common bile duct by malignant tumour. Postimplantation examinations revealed no complications caused by the stent. Two of the patients have since died from their underlying disease, the others have survived an average of 10.8 weeks with markedly reduced clinical symptoms, neither jaundice nor signs of cholestasis having recurred. Serum bilirubin concentration had fallen from a mean of 8.2 mg/dl to 1.7 mg/dl 12 weeks after the procedure. Serum alkaline phosphatase activity had similarly fallen, from 515 to 330 U/l. No increase in serum amylase activity was recorded, either initially or in the course of follow-up.

Aged↗
PubMed1990

Transpapillary miniscopy and mini-biopsy of the pancreatic duct.

This paper reports on the new combined examination of peroral transpapillary fine-caliber endoscopy (miniscope 0.5 mm in diameter) with mini-biopsy of the pancreatic duct in 10 patients and 19 surgical pancreas resection preparations. With this technique, endoscopic-retrograde inspection of the whole length of the pancreatic duct is possible without the need for papillotomy. In the case of pancreatic duct changes due to carcinoma of the pancreas, and chronic pancreatitis, the ductal lesions can be inspected. Furthermore, with the aid of a new mini-biopsy forceps (1.5 mm in diameter), material for histological evaluation can be much more efficiently obtained than was normally possible with conventional biopsy forceps (2.2 mm). This new endoscopic-bioptic technique promises to improve the diagnostic reliability in pancreatic duct lesions requiring clarification.

Biopsy↗
PubMed1990

Self-expanding mesh stent for esophageal cancer stenosis.

The implantation of new self-expanding mesh stents (20 mm in diameter, when fully expanded) in a 67-year-old woman with extensive esophageal cancer stenosis is reported. Prosthesis insertion was easily accomplished without the need for general anesthesia. The patient has been doing well since. The potential advantages of the new stenting procedure suggest further investigation.

Aged↗
PubMed1989

Transpapillary cholecystoscopy.

This report describes the inspection of the inside surface of the gallbladder and the cystic duct by a newly available catheter and endoscopic system, with the aid of retrograde endoscopy. Using our newly developed endoscopic retrograde catheter system, we were able to cannulate the gallbladder in nearly 80% of all cases. No papillotomy is needed. Owing to its high degree of flexibility and relative robustness, coupled with brilliant optical quality, the new 0.5 mm miniscope permits careful and virtually complete inspection of even such small structures as the tortuous cystic duct.

Catheterization↗
PubMed1989

[Endoscopy and biopsy of the pancreatic duct--a new method of pancreas diagnosis].

Newly developed endoscopes make it possible to inspect the major papilla, the pancreatic and choledochal ducts without previous papillotomy. First results of this new method in surgical specimens and patients are presented. Ductal dilatations, and irregularities as well as secretion plugs and calcifications are characteristic phenomenons of chronic pancreatitis; the diagnosis of a malignant pancreatic tumour can be made by observing an irregular compression of the pancreatic duct and the infiltration of its wall. Perhaps by this method precursors of ductal pancreatic cancer will be recognized. We assume that ERCP will be supported by this method.

Ampulla of Vater↗
PubMed1988

ERCG: endoscopic retrograde catheterization of the gallbladder.

This report describes a newly developed catheter system with the aid of which the cystic duct and gallbladder can be reliably catheterized, retrograde, via an endoscope. In 8 out of 10 autopsy preparations, transpapillary gallbladder catheterization was successfully achieved, with an average fluoroscopic duration of 12 minutes (range: 4-20 minutes). Neither macroscopic nor microscopic traumatization of the gallbladder was observed. The procedure described in this paper opens up a diagnostic and therapeutic approach to the gallbladder.

Adult↗
PubMed1988

Miniscopes in gastroenterological endoscopy--inspection of the gallbladder and the biliary and pancreatic duct systems in autopsy specimens.

This report describes a newly available endoscopic system, the purpose of which is to inspect the common bile duct, gallbladder, cystic duct and the pancreatic duct with the aid of retrograde endoscopy. A miniscope examination of the gallbladder was carried out in eight out of ten autopsy specimens, and the entire pancreatic duct was inspected in nine out of ten specimens after successful transpapillary catheterisation. The procedure described in this paper opens up a new diagnostic and therapeutic approach to the gallbladder, biliary tree and the pancreatic duct.

Autopsy↗
PubMed1985

[Does self-measurement of blood pressure improve compliance in hypertensive patients?].

To increase compliance in antihypertensive therapy, adherence was measured before and after distribution of non-automatic blood pressure devices. After 2 weeks of taking placebo, 37 essential hypertensive patients, both male and female, were treated over a period of 8 months with an antihypertensive combination drug containing triamterene. At each follow-up, compliance was checked by triamterene urine fluorescence. In the third month of therapy all patients were given a non-automatic blood pressure device. The results showed that self-recording of blood pressure increased the compliance rate of the group from 65% at the beginning of the trial to 81% at the end. Patients who showed poor adherence and consistently insufficient blood pressure values increased their compliance rate from 0% before to 70% after self-measuring of blood pressure. In the light of these findings, self-recording of blood pressure can be recommended in cases where compliance is suspected to be poor and blood pressure is inadequately controlled.

Adult↗
PubMed1985

Atenolol versus pindolol: side-effects in hypertension.

This randomized crossover out-patient study was designed to compare the antihypertensive effects of atenolol and pindolol. After a wash-out period of two weeks in pretreated cases, 107 patients with essential hypertension were given either atenolol 100 mg once-daily or pindolol 20 mg slow release (SR) once-daily. Both atenolol and pindolol lowered blood pressure over the 24 week period. The diastolic blood pressure reduction was significantly greater (p less than 0.01) with atenolol than with pindolol. Before beta-blocker therapy, many patients had already experienced side-effects such as fatigue, sleep disturbances and dreams. This probably relates to the high sensitivity of the analogue scale used to assess side-effects, and to the high incidence of such symptoms in untreated patients. As the study progressed there was a reduction in the frequency of fatigue (p less than 0.03) and dreams (p less than 0.05) in both groups, whereas sleep disturbances significantly increased under pindolol (p less than 0.05) but decreased under atenolol (p less than 0.05). The only important side-effect difference between the two beta-blockers was the higher incidence of sleep disturbances with pindolol which may be due to the higher lipophilicity of this beta-blocker.

Adolescent↗
PubMed1984

Long-term effect of captopril on kidney function in various forms of hypertension.

To study long-term effects of captopril on renal function in patients with various forms of severe hypertension, serum creatinine values were monitored in 76 patients under captopril therapy over a period of up to 3 years. Three different groups were formed: patients with essential hypertension (n = 37); patients with renovascular hypertension (n = 20); patients with renal parenchymatous hypertension (n = 19). In each of the three groups reduction in blood pressure was accompanied by increases in serum creatinine. However, both changes were more pronounced in patients with renovascular hypertension. In this group only the rise in creatinine was statistically significant and showed a slight progression with duration of captopril treatment. Group specific analysis revealed that the increase was smaller in patients with unilateral (n = 16) renovascular disease than in those with bilateral (n = 4) involvement, but in the former it was still significantly higher than in patients with essential or renal parenchymatous hypertension. Separation of patients according to the underlying disease of renovascular hypertension showed that renal function deteriorated less in patients with arteriosclerotic origin (n = 10) than in those with fibromuscular dysplasia (n = 8). Statistical evaluation of subjects with renovascular and essential hypertension still revealed significant differences in creatinine when the patients with initial plasma renin activity (PRA) below and above 6 ng/ml X 3 h were compared separately. A significant correlation (r = 0.73; P less than 0.05) between blood pressure reduction and creatinine changes was obtained only for patients with renovascular hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Captopril↗