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Biomedical subjects

M Classen

Publications and source records attributed to M Classen.

At least 361 records · Page 20Linked to original sources
PubMed1983

Dacarbazine (DTIC)-induced human liver damage light and electron-microscopic findings.

The first electron-microscopic description of DTIC-induced human liver injury is presented. A 61-year-old man developed signs of hepatic failure during the second treatment cycle with DTIC for malignant melanoma. Light-microscopic examination revealed extensive centrilobular liver necrosis. Terminal hepatic venules did not show any signs of vasculitis or thrombosis and there was a lack of inflammatory infiltration. At the ultrastructural level intracytoplasmic, membrane-bound, organelle-free vacuoles were found in the hepatocytes. Liver cells showed bleb formation. Bile canaliculi were dilated and their microvilli flattened. In the pericanalicular exoplasm electron-dense fibrillary material, thought to be of microfilamentous origin, accumulated. The patient received 250 mg methylprednisolone i.v. at the very onset of symptoms and was discharged 12 days after the peak rise of transaminases with normal liver parameters.

Chemical and Drug Induced Liver Injury↗
PubMed1982

[Excretory pancreatic function: comparison of indirect function tests with the secretin-cholecystokinin test].

In 72 patients with chronic pancreatitis results of tbe secretin-cholecystokinin test were compared with those of several indirect test of pancreatic function (faecal fat content, chymotrypsin activity in faeces, peptide-PABA test, fluorescein-dilaurate test and weight of faeces). In 46 patients with markedly impaired pancreatic secretion the indirect tests were abnormal in 56-83% of cases. In 26 patients with normal or upper-limit-of-normal excretory function the same tests were abnormal in 15-77%. These results indicate that indirect tests of pancreatic function are of only limited value in the early diagnosis of pancreatic insufficiency.

Adult↗
PubMed1982

[Combined irrigation and endoscopy in the treatment of biliary duct stones (author's transl)].

In ten patients with biliary duct stones reoperation was not indicated and endoscopical stone extraction after papillotomy had failed due to the size of the concrements. As in some patients cholecystectomy had been performed several years ago and in others had not been done yet, treatment was commenced via an endoscopically inserted nasobiliary tube using media dissolving cholesterol and calcium bilirubinate stones. Results of treatment were satisfactory and side effects were tolerable. Results were compared with those after treatment with glycero-1-monooctanoate (Capmul 8210). In four patients distribution in the intra and extrahepatic biliary duct system was investigated by admixture of radiographically opaque media with both irrigation fluids. It was shown that both the oily and watery phase of the irrigation media were distributed homogeneously in the duct system and that the stone surface was covered adequately.

Aged↗
PubMed1982

[Clinical features of inflammatory bowel disease (author's transl)].

Inflammatory bowel disease may be caused by virus, bacteria, fungus, parasites or mechanical conditions. Among the inflammatory bowel diseases caused by bacteria salmonellosis and cholera are most important. Their treatment has been revolutionized within the last decade. Instead of the administration of antibiotics the usage of fluids, glucose and electrolytes represents the method of choice. Using the so called "traveller's disease" as an example the pathophysiological aspects of the treatment may be best explained. Etiology and pathogenesis of Crohn's disease, the incidence of which seems to be increasing lately, are still unknown. Before onset of treatment it is essential to establish an exact diagnosis, further to determine distribution and inflammatory activity, as those control the therapy. Salazosulphapyridine and steroids have proved effective drugs. Azathioprine should only be used combined with steroids. Recent investigations suggest that certain formula diets, such as e. g. Survimed, may be useful in the management of the disease as well.

Azathioprine↗
PubMed1982

[Zollinger-Ellison syndrome--changes in surgical therapy. Analysis of 27 patients].

In 10 out of 27 patients with a Zollinger-Ellison syndrome a gastrin-producing tumor was removed, in 5 localized with phlebography. In the remaining 12 patients the diagnosis of a gastrinoma was based on clinical data only. The 10 patients with surgically proven gastrinoma did not differ in their fasting blood-glucose levels, rise of gastrin serum levels after administration of secretin and calcium, in acid production patterns nor in survival time from those 12 patients in whom no gastric-producing tumor had been found. 5 of the 27 patients died, 4 just after surgery. One patient died from advanced malignant disease. In three of our patients localizing diagnostic procedures and consecutive tumor-removal were feasible with the protection of H2-receptor antagonists. The trend in the treatment of ZES goes away from elective total gastrectomy towards conservative treatment with H2-receptor antagonists in view of the low morbidity and the attempt of curative treatment by tumor-removal.

Adult↗
PubMed1981

[Endoscopic determination of the size of gastrointestinal ulcers (author's transl)].

A new method based on computer-assisted semi-automatic equipment for stereological analysis has been developed to measure ulcer size endoscopically. The main component is a graphic measuring table connected with a computer which is itself linked to a television monitor. The endoscopic picture is transmitted to the television monitor and the ulcer area is measured directly on the monitor using electronic overlay markers. The trace of the measuring markers remains visible on the monitor so that every lesion demonstrated is accurately outlined. The computer calculates the ulcer area by relating it to a known endoscopically inserted reference area. Numerous measurements from various distances, various angles of view and with variable reference area sizes showed the error to be 4.2 +/- 0.5%. Measurements by six different investigators showed variations of 2.9 +/- 1.2%. These results document the reliability of endoscopic planimetrics of gastrointestinal ulcers.

Anthropometry↗
PubMed1981

[Endoscopy of esophageal cancer (author's transl)].

The late stages of symptomatic esophageal carcinoma rarely present diagnostic difficulties. Nevertheless, the tumor must be bioptically analyzed and defined to decide on proper treatment. Our future aim is to diagnose esophageal carcinoma at an early stage. Dysphagia should increasingly be accepted as an indication for endoscopy. Biopsy should be accompanied by cytology and vital staining. Regular controls in risk groups should help to improve the poor prognosis of esophageal carcinoma in our country.

Biopsy↗
PubMed1981

Endoscopic approach to papillary stenosis (PS).

Gastrointestinal endoscopy includes important possibilities for the diagnosis and therapy of papillary stenosis (PS). The surface of the papilla of Vater and the ampulla and the terminal common bile duct after EPT can be visualized directly. By means of ERCP the structure of the ampulla, the pancreatic duct and the biliary duct can be demonstrated. The motor activity of the sphincter of Oddi and the drainage time provide valuable information applicable to the diagnosis of PS. Histological examinations of snare and forceps biopsies are of the utmost importance for the differential diagnosis of benign and malignant PS. The advent of endoscopic papillotomy made benign PS an "endoscopic disease". In patients with benign circumscribed PS, surgical sphincterotomy is only rarely indicated. The high success rate of endoscopic papillotomy in PS makes biliary drainage by the transduodenal or the percutaneous transhepatic route superfluous in the majority of cases. We do not regard laser coagulation of papillary cancer as the treatment of choice although it may be indicated in patients who are inoperable or who refuse surgery. - Today, gastrointestinal endoscopy offers the decisive diagnostic and therapeutic approach to papillary stenosis.

Ampulla of Vater↗
PubMed1981

A new method for the endoscopic determination of gastrointestinal ulcer area.

Current endoscopic measurements of gastrointestinal ulcer area using forceps or graduated probes are associated with a high degree of inaccuracy. Based on a computer-assisted, semiautomatic device for stereological analyses, we have developed a new method for the endoscopic determination of ulcer size. The basic elements are a graphical measuring tablet coupled with a computer, the later being connected to TV-monitor. The endoscopic picture is transmitted to the TV-monitor and the ulcerated area is measured directly on the TV-monitor by means of an electronic overlay marker. The trace of the marker remains visible on the screen so that any circumscribed lesion can be labelled exactly. From the relation of a known, endoscopically introduced reference area to the circumscribed ulcerated area, the latter is calculated by the computer. Multiple measurements obtained at different distances, and visual angles, and with different reference areas, revealed an error of 4.2 +/- 0.5%. Inter-observer variation among 6 different examiners was 2.9 +/- 1.2%. These results document the reliability of endoscopic planimetry of gastrointestinal ulcers.

Computers↗
PubMed1981

Pancreatic oncofetal antigen in pancreatic juices. Partial chemical characterization and diagnostic application of a pancreatic cancer-associated antigen.

Antisera were raised in rabbits to an antigenic structure present in fetal pancreas tissue, pancreatic tumor tissue, and pancreatic juices and in sera obtained from pancreatic cancer patients. The first chemical data indicate that this pancreatic oncofetal antigen is distinct from CEA, NCA, and NCA2 and is not glycolipid in nature. Immunoelectrophoretic analyses demonstrate that pancreatic oncofetal antigen is a protein or a glycoprotein, which displays microheterogeneity. The apparent molecular weight of the basic unit of pancreatic oncofetal antigen is estimated to about 40 K. So far 234 pancreatic juices have been investigated for pancreatic oncofetal antigen. Pancreatic oncofetal antigen was detected within the pancreatic juices from 59 of 74 (80%) pancreatic carcinoma patients but could be traced in only 16%-26% of samples obtained from patients with other diseases.

Adult↗
PubMed1981

Alternating treatment of common bile duct stones with a modified glyceryl-1-monooctanoate preparation and a bile acid-EDTA solution by nasobiliary tube.

Twenty patients with bile duct stones were treated via an indwelling nasobiliary tube with a modified Capmul 8210 preparation (GMOC) and alternating with a bile salt-EDTA (BA-EDTA) solution for an average of 12 days. In vitro the dissolution capacity of GMOC and BA-EDTA for cholesterol stones was higher than that of Capmul 8210. The nasobiliary tube was tolerated well for a maximum of 84 days; this renders us independent of the T-tube. The therapeutic success rate of GMOC was 64%, even though we treated mostly old and large concrements. Side effects occurred markedly less than with Capmul 8210. In patients with acute cholecystitis or cholangitis the clinical course improved under therapy, and there was no deterioration of a chronic condition.

Aged↗