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Biomedical subjects

K Ewe

Publications and source records attributed to K Ewe.

At least 91 records · Page 5Linked to original sources
PubMed1984

[Radical operation and recurrence prevention with azulfidine in Crohn disease: a prospective multicenter study--initial results].

The influence of radical versus more restricted operation and Azulfidine prophylaxis was studied in a controlled, partially randomized double blind multicenter trial (16 centres) in 177 patients over 3 years. Early relapse occurred more frequently in the radically operated group (49 vs. 31%) and less frequently under Azulfidine prophylaxis (34 vs. 46%). The radical operation had no advantage over the more restricted procedure and should be abandoned in Crohn's disease.

Clinical Trials as Topic↗
PubMed1984

European Cooperative Crohn's Disease Study (ECCDS): results of drug treatment.

A multicenter double-blind study of the effectiveness of sulfasalazine and 6-methylprednisolone, alone and in combination, was conducted on 452 patients with Crohn's disease. One hundred sixty patients were previously untreated; 292 patients were previously treated. The Crohn's disease activity index (CDAI) was used to determine whether a patient had active (CDAI greater than or equal to 150, n = 215) or quiescent disease (CDAI less than 150, n = 237). Treatment of active disease consisted of high-dose 6-methylprednisolone, 6-methylprednisolone combined with 3 g of sulfasalazine, 3 g of sulfasalazine alone, or placebo, and lasted 6 wk. Patients in remission received maintenance doses of one of these drug regimens for periods of up to 2 yr. One hundred ninety-two patients completed the 2-yr study period. Results were evaluated using life-table analysis and outcome ranking. These methods showed 6-methylprednisolone to be the most effective drug in overall comparison of all patients (p less than 0.001); in previously treated patients (p less than 0.001); and in subgroups: active disease (p less than 0.001), only small bowel disease (p less than 0.05), and both small bowel and colon disease (p less than 0.05). Combination of 6-methylprednisolone and sulfasalazine was the most effective regimen in previously untreated patients (p less than 0.05) and when disease was localized in the colon (p less than 0.001). Sulfasalazine alone was least effective in overall comparison of all patients (p less than 0.05) and in all strata. Drug treatment was of no significant benefit to patients with quiescent disease. Continuous administration of low doses of 6-methylprednisolone, or the combination regimen, was beneficial in patients who responded initially to treatment of active disease. The addition of sulfasalazine, however, offered no advantage.

Adult↗
PubMed1984

[Extent of drug compliance in Crohn disease patients--study of a special ambulatory care unit of a university clinic].

Compliance with therapeutic regimes is an important factor in treatment of chronic diseases often overlooked by therapists. In 123 out-patients with Crohn's disease the reliability in taking the prescribed therapy with salazosulfapyridine (SASP) was studied over an one year period in a special out-patient clinic. 81,3% of the patients took SASP regularly. Sex and age of patients, activity of disease and the intake of other drugs had no influence on the compliance. The patients were fully informed regarding the nature of the illness, the effect of the drug prescribed and the side-effects which may occur. We conclude that these factors; the periodical check up in a special ambulance and a close relation between patient and physician may improve compliance to therapy.

Adult↗
PubMed1984

Endoscopic balloon tamponade for conservative management of severe hemorrhage following endoscopic sphincterotomy.

We report on two patients in whom balloon tamponade was applied for management of severe hemorrhage following endoscopic sphincterotomy (EST). In both patients after EST severe hemorrhage from the papillary orifice was treated by immediate introduction of a special balloon catheter (balloon catheter, model Mainz, Vygon, Aachen). In both patients after 10 minutes no further bleeding was visualized. We conclude that this simple procedure should be taken into account for the conservative treatment of severe hemorrhage following EST.

Ampulla of Vater↗
PubMed1984

[Amebic colitis - differential diagnosis of ulcerative colitis and Crohn disease].

Amoebic colitis rarely develops in patients who had not stayed in a country where amoebiasis is endemic. "Crohn's colitis" was diagnosed in a 33 year old female patient who never had stayed in such an area. The dramatic deterioration of the disease led to revise the early diagnosis. The reported case indicates that the conventional laboratory, endoscopic, histologic, and radiologic examinations don't prove the anamnestically unsuspected amoebic colitis. Since the correct diagnosis was verified by stool and serologic examinations, these should be performed in any doubt of a specific colitis.

Adult↗
PubMed1983

Mechanical gallstone lithotripsy in the common bile duct--in-vitro and in-vivo experience.

A prototype of a mechanical gallstone lithotripter is described. In vitro 29 gallstones were crushed without difficulty. After performing stone crushing in the common bile ducts of 3 corpses, the prepared ducts were not leaky and no damage to the tissue was observed. In 8 patients 10 common bile duct stones were crushed without complications. Mechanical gallstone lithotripsy has proved to be a safe procedure. With its aid the removal of small stones by endoscopic papillary dilatation has become possible. Large stones in patients with a high papillotomy risk can be crushed before extraction.

Ampulla of Vater↗
PubMed1983

Alpha 1-antitrypsin, a reliable endogenous marker for intestinal protein loss and its application in patients with Crohn's disease.

Intestinal protein loss is generally determined by radio-labelled macromolecules. Alpha 1-antitrypsin has been proposed as an endogenous marker for protein losing enteropathy, but different opinions exist about its reliability. In 25 patients with Crohn's disease faecal protein loss was studied with intestinal alpha 1-antitrypsin (alpha 1AT) clearance. Simultaneously, in 10 patients alpha 1AT clearance was compared with faecal 51Cr clearance after intravenous 51Cr-albumin injection. There was a linear relation (p less than 0.05) between alpha 1AT clearance and 51Cr clearance in these cases. In all patients alpha 1AT clearance was raised above control values. alpha 1AT clearance, however, did not correlate with the activity index of Crohn's disease. This index does not contain direct criteria of intestinal inflammation, does not take into account localisation or extent of inflammation, and includes complications such as extraintestinal manifestations, fistuli, stenoses not necessarily related to actual mucosal involvement. It is concluded that alpha 1AT is a reliable marker for intestinal protein loss and that the intestinal changes of Crohn's disease generally lead to an increased protein exudation into the gut.

Adolescent↗
PubMed1983

[Therapy with antacids: dyspepsia with and without ulcer].

1. The effect of antacids on non-ulcer dyspepsia is difficult to assess because of the heterogeneity and complexity of this symptom. Nevertheless, antacids may be used in the treatment of dyspepsia because they have a pronounced placebo effect and they are cheap and harmless. 2. The effect of antacids on ulcer induced dyspepsia is difficult to prove either. However, it is justified to use antacids in ulcer dyspepsia because they induce ulcer healing and because of their symptomatic effect - be it as a drug or as a placebo.

Digestive System↗
PubMed1982

[Endoscopic papillary dilatation: an alternative to papillotomy? (author's transl)].

Endoscopic papillary dilatation (EPD) was performed by means of a balloon catheter in patients with common duct stones of a diameter up to 8 mm. Larger stones had to be crushed before extraction by a modified Dormia basket. The fragments could be removed subsequently using the balloon catheter. A patient with benign papillary stenosis was treated successfully by endoscopic dilatation of the sphincter of Oddi. Dilatation of the papilla offers a papilla preserving alternative to papillotomy in patients with common duct stones and in benign papillary stenosis.

Ampulla of Vater↗
PubMed1982

[(Quality of semen in patients with Crohn's disease) ].

Some reports point to an inhibitory effect of Salzosulfapyridin (SASP) in spermatogenesis. It is not clear whether inflammatory bowel disease itself is influencing the maturation of spermatozoa and whether the activity of the disease is reflected by changes in sperm development. 27 patients with Crohn's disease were studied. 6 were without treatment, 10 received SASP, 11 had both, SASP and methylprednisolone. The sperm analysis was not different between untreated and SASP treated patients. Sperm density was equal in both groups while number of mobile and mature sperms was slightly but not significantly decreased. Sperm quality was on the lower limit of normal. In contrast, all patients with the combined treatment of SASP and methylprednisolone had pathological findings in sperm density, morphology and motility. Crohn's activity index of the latter group was significantly higher than of the patients without or with SASP treatment. It is concluded that pathological sperm analysis of patients with Crohn's disease are not necessarily the consequence of SASP treatment. It seems likely that the disease itself plays a role in the spermatogenesis and that derangements in sperm quality increase with severity of the disease.

Adult↗
PubMed1982

Fecal blood loss in patients with colonic polyps: a comparison of measurements with 51chromium-labeled erythrocytes and with the Haemoccult test.

The quantitative determinations of fecal daily blood loss after intravenous administration of 51Cr-labeled erythrocytes in 44 patients with colonic polyps and in 11 controls were compared with the results of the daily performed Haemoccult test without dietary restrictions. A total of 642 stool specimens was analyzed for 51Cr loss and the Haemoccult test. The mean fecal daily blood loss in the 34 patients with adenomatous polyps of the descending colon and rectosigmoid was 1.36 +/- 0.14 ml/day (mean +/- SEM), in the 10 patients with polyps of the ascending and transverse colon it was 1.28 +/- 0.31 ml/day, and in the 11 controls 0.62 +/- 0.07 ml/day. There was no positive Haemoccult test in the controls. In fecal specimens from patients with polyps in the descending colon and rectosigmoid containing 2.0-3.99 ml blood/day, the Haemoccult-test was positive in 86%. Fecal specimens from patients with polyps in the ascending colon and transverse colon containing equal blood loss yielded a positive Haemoccult test result in 26%. Thus, the positivity of the Haemoccult test is determined by the fecal daily blood loss and the anatomic location of colonic bleeding sites.

Chromium Radioisotopes↗
PubMed1981

Bleeding after liver biopsy does not correlate with indices of peripheral coagulation.

Contraindications for percutaneous liver biopsy are often derived arbitrarily from coagulation status of peripheral blood, but no objective data are available on the duration of bleeding from the site of liver biopsy. "Liver bleeding time" (LBT) was measured after liver biopsy had been performed at laparoscopy in 200 consecutive patients using a 1.8-mm-diameter Menghini needle. LBT was then analyzed in relation to prothrombin time, platelet count, whole blood clot time, length of biopsy cylinder, and liver histopathology. There was no correlation among any of these variables. The average LBT was 4 min 37 sec +/- 3 min 48 sec (SD). In 10 patients LBT was prolonged over 12 min (mean +/- 2 SD), but their clotting indices were not different from those of other patients. Bleeding could be stopped easily by compression if necessary. This lack of correlation may be explained by the high concentration of clotting factors in hepatic parenchyma and by mechanical compression of the needle track by the elastic tissue in the liver. It is concluded that indices of coagulation in the peripheral blood used in this study are unreliable guides of the risk of bleeding after liver biopsy and, hence, are of limited value in determining contraindications to this procedure.

Biopsy↗