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Biomedical subjects

E Pratschke

Publications and source records attributed to E Pratschke.

At least 37 records · Page 2Linked to original sources
PubMed1990

Increased epidermal growth factor receptors in gastric carcinomas.

The epidermal growth factor and the homologous alpha-tumor growth factor are mitogenic polypeptides that act by binding to the epidermal growth factor receptor. The present study investigated whether increased production of epidermal growth factor/alpha-tumor growth factor or increased density of epidermal growth factor receptors may occur in gastric carcinomas as compared with normal mucosa from the same individuals. Epidermal growth factor receptors were measurable by (125I)EGF-binding assays in 13 of 15 normal mucosas and in 15 of 15 carcinomas. The epidermal growth factor-binding capacity was significantly higher in carcinomas than in mucosa. A comparison of pairs of mucosa and carcinomas showed an increase of epidermal growth factor receptors in 9 of 15 carcinomas, no change in 3, and a decrease in 2 carcinomas. One mucinous adenocarcinoma contained extreme numbers of epidermal growth factor receptors (2445 fmol/mg protein) corresponding to a 320-fold increase over normal mucosa. Epidermal growth factor-like activity was increased in 2 of 22 carcinomas compared with mucosa. We conclude that relative overexpression of epidermal growth factor receptors occurs in a fraction of gastric carcinomas. Whether increased expression of epidermal growth factor receptors is associated with particular patterns of tumor progression needs to be investigated.

Adult↗
PubMed1990

[Surgical bile duct revision--indications, technique, results].

Nonsurgical methods compete with common bile duct exploration (CBDE) in the treatment of choledocholithiasis. Following CBDE residual duct stones are found in 6% of cases and the mortality is 2%. In our patients (n = 373) the numbers were 5.4% and 1.6% respectively. The lowest rates of residual duct stones were seen following a combination of intraoperative cholangiography and choledochoscopy. CBDE is indicated when cholecholithiasis is discovered intraoperatively, in low-risk patients with gallbladder and bile duct stones, after unsuccessful endoscopic procedures, in cases, of other pathologic findings of the bile duct requiring surgery or even in younger patients after prior cholecystectomy.

Cholangiography↗
PubMed1989

Epidermal growth factor receptors and epidermal growth factor-like activity in colorectal mucosa, adenomas and carcinomas.

The epidermal growth factor (EGF) and alpha-tumor growth factor are mitogenic proteins which bind to the EGF-receptor and may play a role in carcinogenesis or tumor progression. Our study investigated whether colorectal carcinomas and adenomas express altered levels of EGF-receptors or overproduce EGF-like activity by comparing histologically normal mucosa to carcinomas resected from the same patients. EGF-receptors were characterized by radioligand binding studies. Carcinomas contained unchanged or decreased levels of EGF-receptors in 13/16 and moderately increased levels in 3/16 patients as compared to normal mucosa. Adenomas obtained from 2 patients with familial polyposis coli and from a third patient with a coincident carcinoma had similar numbers of EGF-receptors as normal mucosa. EGF-like growth factors, in contrast, were significantly elevated in carcinoma extracts as compared to extracts from normal mucosa of the same patients. Adenomas did not contain elevated levels of EGF-like activity. We conclude that increased expression of EGF-receptors is infrequent in colonic adenocarcinomas. Increased production of EGF-like growth factors may frequently occur but seems to be associated with tumor progression rather than with premalignant lesions as represented by adenomas.

Adenomatous Polyposis Coli↗
PubMed1989

Percutaneous transcatheter occlusion of cystic duct stump in postcholecystectomy bile leakage.

Postoperative cystic duct fistula is an uncommon complication after cholecystectomy. Nonoperative management includes endoscopic retrograde or percutaneous transhepatic biliary drainage, and percutaneous catheter drainage of fluid collections. Transcatheter occlusion of the leaking cystic duct remnant proved a valuable alternative treatment when biliary stenting failed for technical reasons.

Aged↗
PubMed1989

Low-dose ursodeoxycholic acid prolongs cholesterol nucleation time in gallbladder bile of patients with cholesterol gallstones.

The high rate of stone recurrence represents a drawback of non-surgical therapy of cholesterol gallstone disease. Although most studies report that long-term bile acid treatment does not have protective effects, preliminary results suggest that low-dose ursodeoxycholic acid decreases the rate of gallstone recurrence in a subgroup of younger patients. To clarify the underlying mechanism we investigated whether low-dose ursodeoxycholic acid treatment influences biliary cholesterol saturation and/or nucleation time of cholesterol. Ten patients with cholesterol gallstones and functioning gallbladder received 250 mg ursodeoxycholic acid/day at bedtime 6-10 days prior to cholecystectomy. Eleven patients with cholesterol gallstones without treatment served as controls. Cholesterol crystals were present in the gallbladder bile of 7 out of the 10 patients receiving ursodeoxycholic acid and in all control biles. Ursodeoxycholic acid treatment significantly (P less than 0.02) decreased the cholesterol saturation index (mean +/- S.E.: 0.94 +/- 0.05 vs. 1.43 +/- 0.18) and led to an approximately 5-fold prolongation (P less than 0.005) of the cholesterol nucleation time (mean +/- S.E.: 12.0 +/- 2.4 vs. 2.3 +/- 0.7 days). We conclude that low-dose ursodeoxycholic acid might be effective in the prevention of post-dissolution gallstone recurrence by both decreasing cholesterol saturation and prolonging cholesterol nucleation time.

Adult↗
PubMed1989

[Percutaneous drainage treatment of primary liver abscesses].

28 primary liver abscesses, including 9 amoebic abscesses, in 24 patients were drained percutaneously. Indication for drainage in amoebic abscesses was imminent rupture and clinical symptoms as pleural effusion, lung atelectasis and pain. 95% of the primary abscesses were cured by percutaneous drainage and systemic antibiotic treatment. There was one recurrence of abscess, which was managed surgically. Reasons for drainage failure were: tumour necrosis and tumour perforation with secondary liver abscess.

Adult↗
PubMed1989

[Percutaneous drainage of fistula-associated abscesses and biliary fistulas].

33 abdominal abscesses associated with fistulae in 31 patients were treated by percutaneous drainage. 19 of these patients had had surgery immediately preceding the drainage. In 64% the percutaneous drainage led to a diagnosis of an internal fistula. Additional therapeutic measures, because of the fistula, were necessary in 45% (operation, biliary drainage, repositioning of catheter). The average duration of drainage was 29 days. 77% of those abscesses which could be drained were treated successfully. Mortality in the entire series was 19%.

Abdomen↗
PubMed1989

[Percutaneous cholecystostomy in treating acute cholecystitis in patients at risk].

Percutaneous cholecystostomy was performed in 17 poor surgical risk patients. 16 patients developed acute acalculous cholecystitis postoperatively in the intensive care unit, 1 patient had an acute cholecystitis with calculi. Diagnostic imaging using CT and US was specific for acute cholecystitis in 58% only. Percutaneous cholecystostomy was the definitive treatment in 69% of the patients. Additional cholecystectomy was required in 3 patients with complicated cholecystitis, in 1 patient with bile leakage after catheter dislocation and in 1 patient with gallbladder calculi. 3 patients died, 2 of them from reasons unrelated to the gallbladder disease. Radiology-guided percutaneous cholecystostomy performed by a transhepatic approach is a safe and effective procedure for acute cholecystitis in high-risk patients.

Acute Disease↗
PubMed1989

Effects of cholecystectomy on the kinetics of primary and secondary bile acids.

Removal of the gallbladder is thought to increase formation and pool size of secondary bile acids, mainly deoxycholic acid (DCA), by increased exposure of primary bile acids (cholic acid [CA], chenodeoxycholic acid [CDCA]) to bacterial dehydroxylation in the intestine. We have tested this hypothesis by simultaneous determination of pool size and turnover of DCA, CA, and CDCA in nine women before and at various intervals after removal of a functioning gallbladder. An isotope dilution technique using marker bile acids labeled with stable isotopes (2H4-DCA, 13C-CA, 13C-CDCA) was used. After cholecystectomy, concentration and output of bile acids relative to bilirubin increased (P less than 0.02) in fasting duodenal bile and cholesterol saturation decreased by 27% (P less than 0.05) consistent with enhanced enterohepatic cycling of bile acids. Three months after removal of the gallbladder bile acid kinetics were in a new steady state: pool size and turnover of CDCA were unchanged. Synthesis of CA, the precursor of DCA, was diminished by 37% (P = 0.05), probably resulting from feedback inhibition by continuous transhepatic flux of bile acids. The fraction of CA transferred after 7 alpha-dehydroxylation to the DCA pool increased from 46 +/- 16 to 66 +/- 32% (P less than 0.05). However, this enhanced transfer did not lead to increased input or size of the DCA pool, because synthesis of the precursor CA had decreased.

Bile Acids and Salts↗
PubMed1989

[Percutaneous drainage treatment of abscess and fluid retention following abdominal surgery].

61 patients with abdominal abscesses and fluid collections as a postoperative complication underwent percutaneous drainage. 60 abscesses, 11 haematomas, 3 steril seromas and 3 bile collections were drained. The fluid collections were associated with biliary or enteric fistulae in 16 cases. The percutaneous drainage was successful in 69%, additional surgery was required in 15%. The overall mortality rate was 13%. Reasons for drainage failure were infected clots, phlegmonic abscesses and pancreas involvement of the abscesses.

Abdomen↗
PubMed1989

Percutaneous cholecystostomy in acute acalculous cholecystitis.

Percutaneous cholecystostomy was performed in 8 poor-surgical-risk patients with acute acalculous cholecystitis. Seven patients had had previous laparotomy, 1 patient a coronary bypass operation. A transhepatic approach was used in all patients. Insertion of the drainage catheters was guided by ultrasound and fluoroscopy. Percutaneous drainage was successful in all patients, with no need for further surgical intervention. Two patients died, for reasons unrelated to the gallbladder disease. Percutaneous cholecystostomy may be definitive treatment for acute acalculous cholecystitis in the critically ill patient.

Acute Disease↗
PubMed1988

Lipid composition and cholesterol nucleation time in gallbladder bile of patients with cholesterol gallstones under choleretic treatment with Febuprol.

The effect of a new potent choleretic drug (Febuprol) on lipid composition and cholesterol nucleation time in gallbladder bile was studied in 8 patients with cholesterol gallstones. Nine untreated patients with cholesterol cholecystolithiasis and functioning gallbladder served as controls. Under Febuprol treatment (3 X 100 mg for 6-10 days) mean concentrations of total bile acids (125.4 vs. 59.5 mmol/l), phospholipids (46.1 vs. 25.6 mmol/l) and total lipids (10.4 vs. 5.9 g/dl) were significantly higher (p less than 0.01) than in controls. No significant difference between both groups was calculated for the mean values of cholesterol (17.8 vs. 13.3 mmol/l), cholesterol saturation index (1.5 vs. 2.1) and cholesterol nucleation time (2.1 vs. 2.6 days). Our findings are compatible with a choleretic effect of Febuprol but no alteration of the rapid cholesterol crystallisation in gallbladder bile of patients with cholesterol gallstones was found.

1-Propanol↗