Search PubMed⌕ Search

Biomedical subjects

H Bosseckert

Publications and source records attributed to H Bosseckert.

At least 19 recordsLinked to original sources
PubMed2001

Ambulatory electrogastrography in patients with sclerodermia, delayed gastric emptying, dyspepsia, and irritable bowel syndrome. Is there any clinical relevance?

Background: Changes in electrogastrographic parameters are described in patients with irritable bowel syndrome, sclerodermia, dyspepsia, and delayed gastric emptying in static measurements. However, no information is available about changes in ambulatory measurements. The objective of this study was to find parameters that discriminate between these diseases using cutaneous 24-h-electrogastrography. Methods: Cutaneous 24-h electrogastrography (EGG) measurements were taken from 20 patients with dyspepsia, 10 patients with systemic sclerosis (sclerodermia, SSc), 7 patients with irritable bowel syndrome (IBS), 7 patients with delayed gastric emptying, and 10 healthy volunteers. Measurements were made using a DIGITRAPPER EGG (Synectics Medical Inc., Stockholm, Sweden) and the accompanying computerized data analysis package (ElectroGastroGram Version 6.30, Gastrosoft Inc., Synectics Medical Inc., Stockholm, Sweden). Frequency and power were compared pre- and postprandially, as well as during the entire day of measurement. Results: The 24-h measurements in healthy volunteers revealed 45.00%+/-12.12% normal values (2.4-3.7 cpm), 30.10%+/-7.15% bradygastric values (<2.4 cpm), and 24.20%+/-7.76% tachygastric values (>3.7 cpm). There was no significant change in frequency between rest and motion, but there was a significant increase in power (P<0.05). There was significantly more bradygastria in patients with dyspepsia periprandially as well as after 24 h (P<0.01) than in healthy volunteers. The mean power of patients with dyspepsia was significantly higher than that of patients with IBS (P<0.05). Conclusion: Cutaneous 24-h-EGG may be used as an additional means of differentiating between dyspepsia and IBS.

Journal Article↗
PubMed2001

Oral zinc therapy in patients with supposed mild zinc deficiency--a critical review.

The importance of zinc in many processes of diseases remains unclear up today. Nevertheless many biochemical or clinical studies let support a high clinical relevance of trace elements especially zinc in the therapeutic concepts of diseases. Unfortunately the border between severe (or real) and mild (or subclinical) zinc deficiency is not clear defined. In addition methodical problems in determination of trace elements and misinterpretations of study results lead to unjustified assignment from several diseases in the group of zinc deficiency disorders. Another current problem is the consideration of bioavailability of oral commercial trace element products. Especially the regulation of zinc uptake in human under normal conditions and in case of zinc deficiency is not clear at this time. These problems let become tangled the actual literature for the clinical active physician at the field of zinc. In this mini review there is given an overview about published clinical studies with oral zinc supplementation in the past years.

Administration, Oral↗
PubMed2000

[Diarrhea as the initial manifestation of medullary thyroid gland carcinoma].

BACKGROUND: With the differential diagnosis of a diarrhea a lot of causes has to be considered. In very rare cases diarrhea can be the first symptom of a medullary thyroid carcinoma (MTC). CASE REPORT: A 28-year-old patient came to the admission department because of persisting diarrhea. A computerized tomography revealed multiple hepatic and pulmonary metastases. A medullary thyreoid carcinoma was found as the cause of it. The serum calcitonin values were highly increased, later the carcinoembryonal antigen (CEA), too. Sandostatin, a radioimmune therapy (131J-anti-CEA antibody) and adriamycin were therapeutically applied. The patient died 24 months after the occurrence of the first symptoms. CONCLUSION: In case of persisting diarrhea the differential diagnosis of a medullary thyroid carcinoma must be taken into consideration and a calcitonin determination has to be arranged. Yet, typical symptoms like struma nodosa, swollen neck lymph nodes or a CEA increase can still be missing in the initial phase.

Adult↗
PubMed2000

Unusual negative side effects of non-steroidal anti-inflammatory drugs in the proximal colon.

Two cases of uncommon side effects of non-steroidal anti-inflammatory drugs (NSAID) are presented which show that in special cases NSAID lesions can be located predominantly in the proximal colon, that NSAID-caused lesions may present themselves as diaphragm-like strictures and that alterations by NSAID in this part of the bowel may bring enormous problems for the differential diagnosis.

Aged↗
PubMed1999

[Success and complication rates of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography--a prospective study].

The aim of the prospective study was to evaluated the efficacy and the complications of 2,820 ERCP-examinations in 1,717 consecutive patients (performed over a three-year period). The rate of success was 82.8% for diagnostic ERCP, 96.6% for endoscopic sphincterotomy, 76.8% for the extraction of stones on common bile tract, 87.5% for drainage in bile tract obstruction, respectively. The rate of all complications amounted to 7.9% (4.9% diagnostic ERCP, 9.2% therapeutic ERCP, in detail: 3.8% acute pancreatitis, 2.1% cholangitis, 1.3% bleeding, 0.2% perforation, 0.5% other respectively). The total mortality was 0.1% (three cases of death). The frequency of complications increased with the number of procedure at the papilla Vateri in patients, who underwent needle knife papillotomy in combination with standard papillotomy.

Adolescent↗
PubMed1999

[Problems in diagnosis and therapy of juxtapapillary, tubulovillous adenoma].

UNLABELLED: Tubulovillous adenoma of the duodenum have a high potential for malignant transformation. An exact preoperative staging and an accurate histological examination are essential in order to choose a proper therapeutic strategy. We report on difficulties in the diagnostic and therapeutic process of a patient with a tubulovillous, juxtapapillary, duodenal adenoma. The adenoma had been resected by means of submucosal excision after infiltrative growth had been excluded endosonographically and malignancy had been ruled out by the histological examination of a taken biopsy. Furthermore no malignant changes had been found in the resected material. However an early recurrence of the tumor questioned the correctness of the first diagnosis. In fact, a retrospective histological examination of the resected specimen revealed an adenocarcinoma, which had been overlooked primarily. Finally the patient underwent duodenopancreatectomy and remains without signs of tumor recurrence so far. CONCLUSIONS: 1. Microinvasion of the submucosa can not be excluded endosonographically. Therefore endosonography can not specify the dignity of an unknown tumor with a sufficient safety, especially if there is only an intramural growth of the tumor without transmural spread. 2. Because of high recurrence rates and a distinct frequency of malignant transformation of duodenal adenomas, a submucosal resection should only be performed in high-risk patient. 3. In that patients the resected material has to be examined as accurately and subtly as possible to rule out a submucosal microinvasion. 4. Based on the above mentioned radical surgery (duodenopancreatectomy) should be performed in all normal risk patients with juxtapapillary adenomas.

Adenocarcinoma↗
PubMed1998

Gastric wall abscess, a rare endosonographic differential diagnosis of intramural tumors: successful endoscopic treatment.

Abscesses in the gastric wall are extremely rare. As the mucosa remains intact in most cases, clear differential diagnosis is required in order to distinguish the condition from the more frequent intramural mesenchymal tumors. Endoscopic ultrasonography provides a valuable tool for imaging intramural tumors, but this approach does not allow a definitive assessment of malignancy. We report about two patients with intramural abscesses in the gastric wall. Endosonography showing eccentric tumors from the gastric wall in the two patients. The endosonographic image was inhomogenous, the wall layer structure of the gastric wall was not preserved. A laparotomy was carried out on the first patient. In the second case, the diagnosis was easy, as pus was emptying from a small opening in the mucosa, which had already been detected at gastroscopy. Endoscopic intervention was carried out based on the endosonographic findings. In one patient, mucosa and submucosa were opened by a needle knife. These cases show that gastric wall abscesses do not have a typical endoscopic ultrasound appearance. However, endosonography is an essential method prior to endoscopic interventional therapy.

Abscess↗
PubMed1998

Ecstasy pimples - a new facial dermatosis.

Ecstasy (XTC) has become a popular drug in the rave, dance and techno scene. Several severe disorders due to drug addiction have been described but no dermatological symptoms. We report on 2 patients (20-year-old female, 21-year-old male) with medical problems after taking XTC. Both developed a facial rash with reddish pimples after oral intake of XTC. The distribution resembled either periorificial dermatosis or acneiform rash without white- or blackheads. The lesions cleared without specific treatment. We suggest that XTC pimples represent an acneiform dermatosis in young people taking designer drugs. Though the dermatosis itself seems to be mild, it may be a cutaneous marker for drug abuse.

Adult↗
PubMed1998

[Value of endosonography in diagnosis of diffusely growing stomach carcinomas].

The diagnosis of diffuse type gastric carcinoma is very difficult. The delay of diagnosis is often due to false-negative endoscopic and histologic evaluation. The architecture of the stomach can be clearly visualized by endosonography. Therefore, already minor destructions of the gastric layers can be found. The endosonographic picture includes the presence of the layers, which are larger and of irregular contour. In infiltrating gastric cancer typically the submucosal layer and the muscularis are concentrically enlarged and appear folded. Based on the endosonographic picture diffuse type gastric carcinoma has been diagnosed in 32 patients. When compared to the histologic diagnosis after gastrectomy or autopsy the accuracy of the endosonographic diagnosis was 87.5%, (28 out of 32 patients). From the remaining four patients diagnosed to have diffuse type gastric cancer by endosonography three patients turned out to have malignant infiltrating tumors of different histologies. Therefore, the positive predictive value of endosonography in detection of infiltrating malignant tumors was 96.8% in our group. In contrast the accuracy of preoperative histologic diagnosis by biopsies was only 58%. Suspicious results of gastroscopy, especially in combination with a negative biopsy, should lead to further evaluation by endosonography to detect diffuse type gastric cancer earlier.

Adenocarcinoma, Scirrhous↗
PubMed1997

H2-receptor antagonists and antacids have an aggravating effect on Helicobacter pylori gastritis in duodenal ulcer patients.

BACKGROUND: Antacids, such as aluminium-magnesium hydroxide (AIMg(OH)3), or H2-receptor antagonists, such as ranitidine, are common drugs used for treating peptic ulcer disease and acid-related symptoms. METHODS: In a prospective double-blind controlled study, 174 patients were randomized to a 4-week course of treatment with either AIMg(OH)3 (acid-binding capacity: 280 mval/day) or ranitidine 300 mg for active Helicobacter pylori-associated duodenal ulcers (as determined by histology and the urease test). Before and after treatment, two biopsy specimens each were obtained from the antrum and corpus, and the grade and activity of gastritis, as well as H. pylori density, were determined using a score ranging from 0 = none to 4 = severe. RESULTS: Pre- and post-treatment histology were available for 138 patients (AIMg(OH)3: 67, ranitidine; 71). Treatment with AIMg(OH)3 significantly increased the activity of corpus gastritis (Wilcoxon signed-rank: P = 0.0014), while ranitidine treatment significantly increased both the grade and activity of corpus gastritis (P = 0.0002 and P = 0.0001 respectively). In the antrum, both regimens provoked a significant increase in the frequency of intestinal metaplasia, but this may be a consequence of sampling error. CONCLUSIONS: Ranitidine and AIMg(OH)3 have an aggravating effect on H. pylori gastritis in duodenal ulcer patients. This should be considered a side-effect of the respective drugs and is more pronounced with ranitidine.

Aluminum Hydroxide↗
PubMed1996

Increased biliary secretion of cysteinyl-leukotrienes in human bile duct obstruction.

BACKGROUND/AIMS: The pathophysiological role of leukotrienes in liver disease is not well understood. Redistribution or enhanced formation in cholestatic states may result in increased hepatic concentrations that are expected to contribute to liver injury. To disclose the potential role of cysteinyl-leukotrienes in chronic liver diseases, we studied biliary and urinary secretion in the model situation of relief of bile duct obstruction. METHODS: Concentrations of cysteinyl-leukotrienes were determined in bile and urine of patients with extrahepatic biliary obstruction in the course of therapeutic decompression by endoscopic or transhepatic techniques. Leukotrienes were measured by radioimmunoassay after HPLC separation. Concentrations of bile acids in bile and serum were measured for comparison. RESULTS: Bile collected 2 h after decompression contained high concentrations of leukotrienes (57.5 +/- 22 microM). Biliary secretion decreased over 24 h reaching equilibrium values after 48-72 h (2.8 +/- 1.7 mM and 6.4 +/- 6.6 microM, respectively). Total bile acid concentration in serum followed a similar time course. In contrast, biliary bile acid concentration showed high interindividual variations. Bile contained all leukotriene C4, D4, E4 and NAc-LTE4, but LTC4 was predominant. Urinary leukotriene secretion in cholestasis (199.7 pmol/mmol creatinine) was less than 7% of maximal biliary secretion. It further decreased to 116.4 pmol/mmol creatinine within 72 h. Urine also contained all species of cysteinyl-leukotrienes, but the relative amounts of LTE4 and NAc-LTE4 were higher than in bile. CONCLUSIONS: Formation of cysteinyl-leukotrienes is increased in obstructive jaundice resulting in increased urinary excretion before and both biliary and urinary excretion after relief of the obstruction. Predominance of LTC4 suggests that the secreted leukotrienes are newly formed. Increased synthesis and retention of hepatic cysteinyl-leukotrienes may contribute to hepatic and extrahepatic consequences of cholestasis.

Aged↗
PubMed1995

Zinc concentration in serum and leucocytes in chronic inflammatory diseases.

In connection with inflammatory diseases of various origins an increasing amount of research has been directed towards trace elements, in particular zinc. However, proving changes in the zinc concentration of organisms or single cells still encounters major methodological difficulties. This is also probably the reason why many of the research findings to be found in current publications still significantly differ from one another. The present study utilizes a novel leucocyte-preparation method, which proved to be very reliable as regards the constancy of measured values. Thus, results obtained in 1989 which show a significant decrease in leucocyte zinc concentrations of patients with Crohn's disease were confirmed (1) as well as extended to the clinical pictures of Colitis ulcerosa and chronic pancreatitis of ethylic origin by studying a group of patients. Significant changes in serum zinc levels could not be proved. There was also no correlation between the leucocyte zinc concentrations and the serum zinc concentrations, on the one hand and the clinical parameters C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), body weight, humeral muscle area as well as activity of the disease, on the other.

Adult↗
PubMed1995

Autoantibodies to Auerbach's plexus in achalasia.

Achalasia is a motor disorder of the oesopagus characterized by decrease in ganglion cell density in Auerbach's plexus. The cause of the lesion is unknown. This is to repeat on the occurrence of autoimmune phenomena in patients with achalasia, in particular circulating antibodies against Auerbach's plexus and its possible meaning. IgG-antibodies against Auerbach's plexus were determined by standard indirect immunofluorescence. Antibodies to the cytoplasm of Auerbach's plexus were found in 37 of 58 patients with achalasia at variable stages of the disease (I-IV) with a disease duration ranging from 1 to 20 years but only in 4 out of 54 healthy controls (specificity 93%, sensitivity 64%, p < 0.0001), and in none of 12 patients with Hirschsprung's disease as well as 12 patients with cancer of oesophagus and only in one of 11 patients with peptic oesophagitis as well as in one of 13 patients with myasthenia gravis. The present observations suggest that autoimmunity to Auerbach's plexus plays a role in the pathogenesis of achalasia, the mechanism of action is unknown.

Adolescent↗
PubMed1993

[Early evening and late evening administration of roxatidine acetate in therapy of duodenal ulcer].

In a multicenter, placebo-controlled, comparative trial with 196 general practitioners and internists 730 18 to 70 year-old patients with endoscopic evidence of a duodenal ulcer were enrolled. Each group of 365 patients received 150 mg Roxatidine acetate once daily, either late in the evening (bedtime administration, between 10.00 p.m. and 11.00 p.m.) or early in the evening (after dinner, between 6.00 p.m. and 7.00 p.m.). The endoscopic control revealed that the ulcers healed after four weeks of treatment in 74% (bedtime administration) and 77% (administration early in the evening), respectively. There was no significant difference ascertained between both groups. At the last visit, epigastric pain was removed during the day in 86% and during the night in 90% in both groups.

Adolescent↗