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Biomedical subjects

M Classen

Publications and source records attributed to M Classen.

At least 343 records · Page 19Linked to original sources
PubMed1984

Somatostatin-containing cells in the extrahepatic biliary tract of humans.

We investigated the presence of endocrine cells in the human extrahepatic biliary system using the avidin-biotin-peroxidase complex method. Twenty gallbladders obtained during operations for cholelithiasis, large portions of three common bile ducts obtained during Whipple's procedure for carcinoma of the head of the pancreas, and 155 endoscopic transpapillary biopsy specimens taken during control endoscopy from patients who had had a previous endoscopic sphincterotomy were examined. Somatostatin-containing cells were found in the glandular epithelium of the ampulla of Vater and the bile ducts. Only the surface epithelium in the ampulla contained endocrine cells. All somatostatinlike immunoreactivity was confined to cells and could not be detected in nerves. No somatostatinlike immunoreactivity was found in the gallbladder. These findings reveal a morphologic basis to reported actions of somatostatin on bile flow.

Ampulla of Vater↗
PubMed1984

Radiological and ultrasonographic investigations with respect to patient selection and monitoring for chemical gallstone dissolution.

786 consecutive patients with suspected gallstones investigated radiologically and ultrasonographically, 231 (33.0%) were found to have stones. Radiological examinations showed that 59.3% of these were suitable for chemical dissolution with cheno- or ursodeoxycholic acid. The percentage of treatable patients fell from age 20 to age 65 from 71% to 48% (p less than 0.05) and then rose again to 61% (not significant). The benefit of litholysis is greater, the earlier it is begun. The results are in disagreement with those of two studies in operated patients. Here only 19-24% were suitable for stone dissolution. Comparative ultrasonographic and radiological studies in 23 patients have shown that monitoring of patients during litholysis can be carried out ultrasonographically. Stone size measured ultrasonographically corresponds sufficiently accurately with that obtained radiographically.

Adult↗
PubMed1984

[New technics].

Explore the source record for details and available documents.

Endoscopes↗
PubMed1984

Detection of atrial and ventricular septum defects by transoesophageal two-dimensional echocardiography with a mechanical sectorscanner.

Two-dimensional (transthoracic) echocardiography (2DE) and two-dimensional endoscopic (transoesophageal) echocardiography ( 2DEE ) were performed in 19 consecutive patients with atrial septum defect (ASD), and in 17 controls, 3 with ventricular septum defect (VSD) and 14 with various diseases. In detection of ASD the sensitivity was 61% (11/18) and the specificity 88% (2/17) with 2DE whereas 2DEE revealed a sensitivity of 95% (18/19) and a specificity of 100% (0/17). 2DEE enabled to visualize the VSD in all 3 patients (2DE in 1/3). With 2DEE the site and size of the atrial septum defects could be estimated well as confirmed in 14 patients who underwent cardiac surgery. The lateral resolution of the 7.5 MHz transoesophageal probe was about 0.5 cm. Further studies are required to clarify if cardiac catheterization prior to surgery of an ASD may be replaced by 2DEE .

Adult↗
PubMed1984

Anatomical aspects in ultrasonic endoscopy.

The combined use of gastroscopy and sonography will yield both methods an enhancement of its diagnostic range. By this new method, ultrasonography has to face new aspects of the examination. Endosonographical examinations were performed in 26 normal patients. The technique of endoscopic ultrasound tomography ( EUT ) is complicated and different because of the orientation, the predestined nature of the GI tract, and the limited movements within the GI tract. Seven standard positions are proposed: distal duodenum, papilla Vateri, bulbus duodeni, antrum ventriculi, corpus ventriculi, fundus ventriculi, and distal oesophagus. But up to now, there has been no general examination technique for the visualization of the individual organs. Nevertheless, with EUT new sonographic windows were opened. The first experiences show that the contours of organs and vessels may be imaged with a distinction unknown up to now. The sector and magnifying effect of EUT may contribute to the knowledge of anatomical, topographical and pathological conditions and changes.

Adult↗
PubMed1984

Detection of biliary stones by means of endosonography.

For its particular qualities, endoscopic ultrasound tomography ( EUT ) appears to be a suitable method for achieving better results in diagnostics of bile duct alterations than conventional UT. In 10 patients with enlarged common bile duct. EUT was carried out with three different prototypes (mechanical sector scan, ultrasound gastrofiberscope . Olympus/ Aloka ). The encouraging results suggest that the high discriminating investigational technique of EUT may be superior to conventional UT for finding common bile duct stones, probably for the differential diagnosis of biliary drainage problems caused by tumors, too.

Adult↗
PubMed1984

Pancreatic pseudocysts and tumors in endosonography.

In endoscopic ultrasound tomography (UT), the ultrasound probe positioned in the stomach has direct access to the pancreatic region. In first experiences, 62 patients were investigated by EUT . 22 of them had a pancreatic infection. EUT seems to be a new method being a valuable complement to conventional UT with a high diagnostic potential and with broad possibilities of application. The increased resolution of structural details of pathological alterations could be of diagnostic value.

Adult↗
PubMed1984

Diagnostic efficacy of endoscopic ultrasound tomography in pancreatic cancer and cholestasis.

By direct access to the target organs and by improved detail resolution, endoscopic ultrasound tomography (EUT) broadens the range of sonographic diagnostics. In this preliminary study, the accuracy of EUT was tested in 34 patients with suspected pancreatic carcinoma and/or painfree jaundice. In all 10 patients with pancreatic carcinoma and in all 6 patients with chronic pancreatitis, the diagnosis made by EUT was correct. Three patients with benign tumors of the pancreas were also diagnosed correctly. The diagnostic sensitivity of EUT in pancreatic cysts was in 4 of 5 cases 80%, in dilatations of the main pancreatic duct in 10 of 11 cases 91%, and in cholestasis in 14 of 15 cases 93%. All 5 common bile duct concrements and all 3 tumors of the papilla Vateri were diagnosed by EUT. The differential diagnosis between pancreatic tumor and pancreatitis was improved by EUT in 1 of 18 cases. In the region of the papilla Vateri, EUT was superior to conventional UT in the diagnosis of ampullary concrements and papillary tumors in 6 of 8 cases (4/5 and 2/3, respectively). EUT could become an important complementary diagnostic method for disorders of the pancreas and the common bile duct with a particular sensitivity for the region of the papilla Vateri.

Adult↗
PubMed1984

Endoscopic biliary drainage.

Endoscopic drainage of the occluded biliary system through the papilla Vateri consists of two different methods, i.e. bilio- nasal and bilio-duodenal drainage. For bilio-nasal drainage a 250-cm- long preformed polyethylene tube is placed above the stenosis to provide the flow out of the congested bile duct. This external drainage is indicated to prevent the blockade of a ductal stone after endoscopic papillotomy (EPT), to treat septic cholangitis, and to dissolve big ductal stones chemically. Insertion of a bilio-nasal probe succeeds in 95% of hte cases. Internal bilio-duodenal drainage is more difficult and succeeds in 87%, its main indication is the inoperable malignant bile duct obstruction. The value of a preoperative biliary drainage is in discussion. Internal bilio-duodenal drainage will perhaps not prolong the survival time of patients with malignant biliary obstruction but it will improve the life quality in the majority of the patients. The decrease of serum bilirubin after the implantation of the prosthesis and the localization of the tumor are of prognostic significance.

Bile Duct Diseases↗
PubMed1983

[Endoscopic-sonographic diagnosis of the stomach wall].

Endoscopic ultrasonography makes it possible to measure and examine the wall of the upper gastrointestinal tract. It complements endoscopic visualization of the surface with analysis of the wall layers. Endoscopic ultrasound imaging reveals five different layers. Preliminary results indicate that benign gastric tumours can be distinguished from infiltrating gastric carcinoma. The extent and adjoining reaction of a gastric ulcer can also be visualized. Endoscopic ultrasonography of the stomach is a method of investigation that can be further developed and already shows considerable diagnostic potential.

Adenocarcinoma↗
PubMed1983

[Treatment of duodenal ulcer with synthetic depot secretin - a double-blind study].

63 inpatients with duodenal ulcer disease were treated with either depot-secretin or placebo. Two different secretin-regimens were used. In group I 18 patients were given secretin twice daily. 11 ulcers from a total of 19 ulcers healed within 3 weeks. In group II 23 patients were given secretin once daily. 21 out of 28 ulcers healed within 3 weeks. In the placebo-treated group 24 ulcers were observed in 22 patients. Of these 15 healed within 3 weeks. There was no statistical difference in the healing rate between the 3 groups. However, depot-secretin significantly improved typical symptoms. Analgetics were used less frequently. Serious side effects did not occur.

Adult↗
PubMed1983

Effect of sucralfate on peptic ulcer recurrence: a controlled double-blind multicenter study.

We entered 174 patients with healed duodenal ulcer and 77 with healed gastric ulcer into a double-blind, placebo-controlled, 6-month trial to investigate the efficacy of 1 g sucralfate twice daily in preventing ulcer recurrence. Endoscopy was performed after 6 months or earlier for symptoms compatible with ulcer disease. The relapse rate in the 126 patients with duodenal ulcer who could be evaluated for efficacy was 14/66 (21.2%) under sucralfate and 30/60 (50%) under placebo treatment (p less than 0.01). No significant difference in relapse rate was found in the 55 gastric ulcer patients who could be evaluated; 11 of 30 (37%) relapsed on sucralfate and 11 of 25 (44%) relapsed on placebo. Among the duodenal ulcer patients in the placebo group, those who had been treated initially with H2-receptor blockers for acute ulcer had significantly more relapses than patients who had been treated with other drugs. The recurrence rate was independent of prior treatment in the sucralfate group. Duodenal ulcer patients with a history of multiple episodes of active ulcer disease had a significantly higher rate of relapse than patients with only a few previous episodes. Both treatments were well tolerated. Two patients in each treatment group complained of nausea and epigastric pain immediately after drug intake. No other drug-related symptoms were observed. We conclude that sucralfate is effective in the prophylaxis of duodenal ulcer. No significant effect was found in the prevention of gastric ulcer recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

Aluminum↗
PubMed1983

[Hydrogen (H2) breath tests in the diagnosis of small intestine diseases].

We have applied the ion sensitive analysis of hydrogen (H2) in expired air in intervals of five minutes for five hours to determine carbohydrate malabsorption. In 19 patients with lactose malabsorption the increase in hydrogen was prior (45, SE 13 min) to healthy volunteers (142, SD 71 min, p less than 0.01). In comparison to blood glucose with the breath test no false positive results were observed. D-xylose absorption measured by breath test and renal excretion for five hours was determined in 24 volunteers and 12 patients with various intestinal diseases. There was a good correlation between both methods. In all patients the area under the concentration-time-curve was elevated (2077, SD 1260 ppm H2/5h) compared to healthy volunteers (434, SD 271 ppm H2/5h, p less than 0.01). Small bowel transit time was determined by ingestion of lactulose. In 32 healthy persons transit time was 85, SD 19 min. In 10 patients an early increase in hydrogen indicated bacterial overgrowth in the small bowel while 14C-Cholylglycine-breath test was abnormal in only six patients. The hydrogen breath test measured by ionsensitive mode is noninvasive, well tolerated, semiquantitative, and ideally suited for screening of intestinal disorders.

Adult↗