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Biomedical subjects

M Classen

Publications and source records attributed to M Classen.

At least 325 records · Page 18Linked to original sources
PubMed1985

Monoclonal antibody defines CA 19-9 in pancreatic juices and sera.

In a retrospective study pancreatic juice samples (n = 213) and corresponding serum samples (n = 110) were assayed for their concentration of monoclonal antibody defined CA 19-9/GICA (gastrointestinal cancer associated antigen). Serum CA 19-9 values were found to be good diagnostic and discriminating markers for pancreatic disorders and were raised (greater than 50 u/ml) in more than 80% of the pancreatic cancer patients compared to 8.5% of the pancreatitis group and none of the control group. In contrast pancreatic juice CA 19-9 values showed a considerable overlap between groups. On the basis of recent molecular data on the monoclonal antibody 19-9 defined antigen(s)--that is, monosialoganglioside, mucin--it is proposed that the discrepancies between serum and pancreatic juice findings are due to a specific undirected endocrine release of the mucin into sera in pancreatic tumour patients while in pancreatic juices of all diagnostic groups high CA 19-9 activities are either owing to coexistence of glycolipid and mucin or that the latter is a physiologically exocrine product.

Antibodies, Monoclonal↗
PubMed1985

Diurnal rhythm of bile lipid composition after cholecystectomy and papillotomy. Postpapillotomy biliary lithogenicity.

The influence of the gallbladder and the sphincter of Oddi on the diurnal rhythm of bile lipid composition was assessed by determining the lithogenic index at 4-h intervals over a period of 24 h in 29 cholecystectomized and papillotomized patients with a nasobiliary tube receiving a normal hospital diet and in 9 during 1-day fast. With a normal diet, biliary cholesterol concentrations dropped during the daytime (p less than 0.05), and total biliary lipid, bile acid, phospholipid, and cholesterol concentrations rose at night (p less than 0.05). During fasting, total biliary lipid, phospholipid, and cholesterol concentrations rose continuously (p less than 0.01). Even with loss of function of the gallbladder and sphincter of Oddi, a diurnal rhythm of biliary lithogenicity persisted, caused mainly by cholesterol increases during fasting. Concomitant increases in phospholipids and, to a lesser extent, bile acids modulated these changes.

Aged↗
PubMed1985

Multiparametric tumor marker (CA 19-9, CEA, AFP, POA) analyses of pancreatic juices and sera in pancreatic diseases.

With respect to their diagnostic utility CA 19-9, CEA, AFP and POA were determined in pancreatic secretions and serum of patients suffering from pancreatic cancer (n = 76/55) or chronic pancreatitis (n = 79/45) and of controls (n = 81/42), respectively. While the determination of AFP and POA both in pancreatic secretions and serum does not permit a differential diagnosis, serum CEA (greater than 10 ng/ml) and CA 19-9 (greater than 50 U/ml) levels were indicative of pancreatic cancer in 30% and 83%, respectively, with a rate of false positive results of 5% and 8.5% confined to the chronic pancreatitis patients. A combination of tumor marker analyses, that is, serum CA 19-9 (greater than 50 U/ml) and pancreatic secretion CEA (greater than 70 ng/ml), proved to be positive in 92.9% of tumor patients with a maximum of 10.5% false positives. Likewise, values of serum CA 19-9 (greater than 50 U/ml) and serum CEA (greater than 10 ng/ml) were found in 85.8% of the pancreatic cancer patients with only 8.8% false positives, which were confined to the chronic pancreatitis patients. These results indicate the superiority of multiparametric tumor marker analyses for the diagnosis of pancreatic cancer, especially when including new monoclonal antibody defined tumor markers.

Antigens, Neoplasm↗
PubMed1985

Omeprazole heals duodenal, but not gastric ulcers more rapidly than ranitidine. Results of two German multicentre trials.

In two double-blind, randomized German multicentre trials the effects of omeprazole 20 mg mane and ranitidine 150 mg b.i.d. were compared for the first time in 334 outpatients with duodenal ulcer and 184 outpatients with gastric ulcer. In patients with duodenal ulcer endoscopically controlled healing rates after two weeks were 72% with omeprazole and 59% with ranitidine (p = 0.012); after 4 weeks 96 and 92%, resp. were healed (n.s.). In patients with gastric ulcer the healing rates after two, four, and eight weeks were 43, 81, and 95%, respectively, with omeprazole and 45, 80, and 90%, respectively, with ranitidine (n.s.). Smoking impaired healing in duodenal, but not in gastric ulcer. Symptom relief was comparable with both drugs. Serious side effects or clinically relevant changes in laboratory screening results were not detected. - Our results demonstrate for the first time that omeprazole 20 mg mane is superior to ranitidine 150 mg b.i.d. in the short-term treatment of duodenal, but not gastric ulcer.

Adolescent↗
PubMed1985

[Endoscopic balloon dilatation in stenosis of the pancreatic duct orifice (case report)].

We report the history and endoscopic treatment of a 63 year old female patient with chronic pancreatitis and stenosis of the pancreatic duct. Several operations of the biliary system had been performed in this patient previously (cholecystectomy 1964, choledochoduodenostomy 1972, revision of the choledochoduodenostomy 1974). In 1976 a chronic pancreatitis and a prepapillary stenosis of the Ductus wirsungianus has been diagnosed by clinical and endoscopic radiological findings. In order to relief pain we performed endoscopic sphincterotomies of the pancreatic duct orifice in 1976, 1977 and 1979. Because of relapsing abdominal pain and worsening of the pancreatic duct stenosis we performed two endoscopic balloon dilations of the proximal pancreatic duct at 20 months intervals. These lowered the pancreatoduodenal pressure difference from 40 mm Hg to normal values (below 13 mm Hg) over more than 12 months. Until today only few--less than ten--endoscopic dilations of the pancreatic duct orifice have been reported. A final estimation of this procedure is premature. However our case should stimulate other groups to consider this new form of therapy in selected patients with chronic pancreatitis and marked stenosis of the pancreatic duct.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1985

Ileal and colonic mucosal bile acids in Crohn's disease and right colonic carcinoma.

Bile acids are supposed to promote colonic cancer. In Crohn's disease, colonic carcinomas are relatively rare. We, therefore, compared ileal and right colonic mucosal bile acids analysed by gas-liquid chromatography in 8 patients with ileal Crohn's disease (14-48 yrs.) and 7 patients with right colonic carcinoma (28-77 yrs.) who underwent surgery. In both ileal and colonic mucosa, nonsulphated bile acid concentrations were somewhat higher in Crohn's disease (20.98 micrograms/g +/- 4.77 SEM; 12.09 micrograms/g +/- 2.55) than in colonic carcinoma (16.06 micrograms/g +/- 3.46; 7.75 micrograms/g +/- 4.28). In ileal mucosa, percentages of lithocholic and deoxycholic acids were slightly higher in colonic carcinoma (3.9%; 23.2%) than in Crohn's disease (1.1%; 14.9%). In colonic mucosa, carcinoma patients had more lithocholic (7.6%) and less deoxycholic acid (11.9%) than patients with Crohn's disease (1.7%; 20.3%). Bile acid sulphate esters were similar in both diseases (ca. 3.0 micrograms/g in ileal, 1.4 micrograms/g in colonic mucosa). Our results show that ileal and right colonic mucosal nonsulphated bile acids tend to be even lower in right colonic carcinoma than in Crohn's disease. This agrees well with our earlier findings of low mucosal bile acid concentrations in patients with left colonic carcinoma (Tokai J Exp Clin Med 8: 59-69, 1983) and does not support the assumption that bile acids are envolved in right colonic carcinogenesis.

Adolescent↗
PubMed1984

[Blood flow measurement in esophageal varices using an endoscopic Doppler ultrasonic probe].

A new ultrasound Doppler probe allows endoscopic measurement of blood flow in oesophageal varices. First investigations in 6 patients show that the measurements are easy and well reproducible. Velocity of blood flow depends on respiration. Cephalad flow increases during inspiration. Caudalad flow may be enhanced by expiration and decreased by inspiration. Cephalad and caudalad blood flow in the same varix may point to drainage by a perforating vein. During and after endoscopic sclerosing, changes in blood flow can be demonstrated. This method gives us the possibility to assess blood flow in oesophageal varices not only for pathophysiological studies, but also for planning and control of sclerosing therapy.

Blood Flow Velocity↗
PubMed1984

[Endoscopic intraductal radiotherapy of high bile-duct carcinoma].

A new method for palliative intraductal radiotherapy of high malignant bile duct occlusion was used in three patients. It consists of insertion of a 4 cm x 0,6 mm iridium-192 wire into the stenosis caused by the tumour. It uses a modified nasobiliary probe which is guided endoscopically retrograde transpapillary. A radiation output of 0.85 Gy/min (85 rd/min) and a requested therapeutic dosage of 60 Gy (6000 rd) at a distance of 0.5 cm lead to in situ position of the wire for about 70 hours. During that time bile flow is effected via the nasobiliary probe. The advantage over previously described methods (percutaneous transhepatic, surgical after installation of U-drainage) lies in a smaller complication rate and improved follow-up treatment as change of the endoprosthesis or repeat irradiation is not associated with renewed tissue trauma.

Adenocarcinoma↗
PubMed1984

[Active immunization against hepatitis B].

The efficacy of the hepatitis B vaccine Hevac B Pasteur was assessed in 277 persons over a period of 6 months. HBs antigen of 5 micrograms/dose was administered three times in monthly intervals. Before each vaccination and after 6 months 18 chemical pathology data and a clinical assessment were performed and all important serologic hepatitis markers (anti-HBs, anti-HBc, HBs antigen, HBc antigen, anti-HBe) were determined radioimmunologically. Within two months antibodies against the surface antigen (anti-HBs) had developed in 85.7% of vaccinees. After 6 months 93.1% of vaccines had become seropositive. Within the first two months anti-HBs-positive findings and higher anti-HBs concentrations occurred significantly more frequently (P less than 0.048) in females than in males. These differences had largely disappeared at the follow-up assessment in the sixth month. In contrast, both parameters (seroconversion rate and anti-HBs concentration) were age-dependent. Among vaccines of less than 25 years of age and of more than 35 there were significant differences after 6 months (P less than 0.005). The hepatitis B vaccine of the Pasteur institute can be considered immunogenic and safe.

Adult↗
PubMed1984

[Viral hepatitis B markers in physicians and medical personnel in the Rhein-Main region].

HBs antigen, anti HBs and anti HBc were determined radioimmunologically on 314 medical students, 585 doctors, 151 medical laboratory personnel and 307 nursing staff. Hepatitis B markers were present in 5.1% of medical students, 23.4% of doctors, 17.9% of laboratory personnel and 18.6% nursing staff. In the different groups there were up to 1.3% HBs antigen-positive persons. A large majority of persons with signs of previous hepatitis B infection had concentrations of both antibodies (anti-HBs and anti-HBc). Between 0.6 and 5.5% of persons were merely anti-HBc positive. Among doctors the number of positive results increased with age and professional exposure, no age dependence as to seropositive or seronegative being found in the other groups. None of the persons tested had been aware of a preceding hepatitis infection. These results indicate that doctors and medical personnel even today are at risk of an undetected viral hepatitis B.

Adult↗
PubMed1984

[Endosonography using a gastrofiberscope].

Gastroscopic ultrasound tomography enables a direct sonographic approach to the upper gastrointestinal tract and the surrounding organs. First experiences show that this new method is characterised by a great diagnostic potential. Its advantages compared with conventional sonography are the avoidance of sonographic obstacles and an improved recognisability of details; part of the examined area is, so to say, enlarged due to the use of high ultrasonic frequencies. With an ultrasonic frequency of 7.5 megahertz, the following processes can be visualised more clearly than with conventional sonographic equipment: processes in the pancreas, cholelithiasis of the common bile duct, hepatic foci, processes in the splenorenal angle, as well as tumours of the stomach and of the esophagus. In cardiology, clear indications are easily recognised, such as the atrial septal defect.

Common Bile Duct Diseases↗
PubMed1984

Electronic endoscopy of the gastrointestinal tract. Initial experience with a new type of endoscope that has no fiberoptic bundle for imaging.

We report on 31 endoscopic investigations using a new type of electronic endoscope which has no fiberoptic bundle for imaging. The device carries on its tip a light-sensitive CCD chip which functions as a TV camera. The signals received are transformed by a processor and displayed on a TV monitor. The upper digestive tract was inspected in 23 patients with the electronic endoscope and in the same session, a fiberoptic-endoscopic esophagogastroduodenoscopy was carried out on 16 of them. The information obtained using the 2 systems differed neither quantitatively nor qualitatively. Because of its external diameter, it was not possible to introduce the electronic endoscope past esophageal stenoses in 2 patients. Preliminary experience with 2 types of colonoscopes in 8 patients strongly indicates that these devices are equivalent, in respect of optical quality, to the fiberoptic endoscopes. The quality and color reproduction of the TV image of the upper and lower digestive tract are excellent. Electronic endoscopy offers great potential for consultation, training and documentation. The patients tolerated the procedure very well.

Adult↗
PubMed1984

Pancreatography in chronic pancreatitis: international definitions.

Terminology in classification of pancreatograms was discussed at a recent international workshop on chronic pancreatitis. A new terminology based on morphological radiographic appearances and a new classification to describe the severity and localisation of pancreatogram changes were agreed. Pancreatograms in chronic pancreatitis are graded as normal or equivocal, or as showing mild, moderate, or marked changes, either diffuse or local. It is hoped that these definitions will help communication between centres, serve as a basis for prospective and comparative studies, and facilitate computerisation.

Chronic Disease↗
PubMed1984

Investigations on the toxicity of bile salt solutions, Capmul 8210 and a bile salt-EDTA solution for common bile duct perfusion in dogs.

The following perfusion media for dissolving bile duct calculi were infused via a cutaneobiliary tube into the biliary tract of 12 mongrel dogs: 4.3% cholate solution, 0.34% chenodeoxycholate solution, Capmul, GMOC (special formulation of Capmul), BA-EDTA and 0.9% saline. Infusion lasted 50 h. Postmortem examination revealed hemorrhagic, partly phlegmonous cholangitis, acute duodenitis, necrosis and abscesses in the liver. The lesions were most pronounced after the cholate solution and with Capmul and GMOC, but were only detected to a slight extent after BA-EDTA and the chenodeoxycholate solution. 0.9% saline had no side effects. The investigations could demonstrate that it is the very irrigation media that today are recommended for treatment of bile duct stones in patients, that cause considerable morphologic side effects. The alternating administration of an EDTA solution with a Capmul preparation may diminish local toxicity of the latter.

Animals↗