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Biomedical subjects

M Classen

Publications and source records attributed to M Classen.

At least 379 records · Page 21Linked to original sources
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↗
PubMed1981

Diagnosis of pancreatic cancer by pancreatic oncofetal antigen (poa) in pure pancreatic juice.

Pancreatic oncofetal antigen (POA) was detected in the pure pancreatic juice by double immunodiffusion assay in a series of patients, using anti-POA prepared by immunizing rabbits with human fetal pancreas homogenate. The test was positive in as many as 72% of the patients with pancreatic cancer studied, whereas only less than 10% of patients with other diseases or normal controls were positive for this antigen, thus suggesting a potential usefulness of the pure pancreatic juice assay for POA in the diagnosis of cancer of the pancreas. The POA has proven to be distinct from such oncofetal antigens as AFP and CEA, to be labile to heating at 85 degrees C, to show beta-mobility on immunoelectrophoresis and to have a molecular weight of approximately 37,000 as estimated by gel filtration chromatography.

Adult↗
PubMed1980

Descending sphincterotomy of the papilla of Vater through a choledochoduodenostomy under endoscopic view. Another variant of endoscopic papillotomy (EPT).

Endoscopic papillotomy required deep cannulation of the papilla of Vater. But retrograde placing of the papillotome in the distal common bile duct is not always possible. Occasionally conditions permitting a descending antegrade cannilation of the papilla are found. An existing choledochoduodenostomy can be used as access for such a cannulation from above. A papillotome, type Erlangen, introduced into the papilla from above, spontaneously adopts the correct cutting direction. With regard to its length the incision has, however, to be monitored endoscopically. Also, undesired additional burns in the duodenum only can be avoided by endoscopic control. This may require the use of a second instrument. The technique described above was successfully applied as another variant of descending papillotomy.

Aged↗
PubMed1980

Experiences with the long standing nasobiliary tube in biliary diseases.

Specially designed longstanding nasobiliary tubes allow to reflect upon some well established therapeutic rules. The safe, decompressing effect of the tube leads to prompt relief of obstructive suppurative cholangitis. Therefore emergency of laparotomy can be avoided in high risk patients. Large common bile duct stones until now have required a large papillotomy with increased frequency of complications. The attempt to dissolve those stones with Capmul is justified on an account of a 50% success rate. Either a very small EPT or even non is necessary in order to insert the tube.

Acute Disease↗
PubMed1980

Ultrasonic tomography by means of an ultrasonic fiberendoscope.

The diagnositc value of ultrasonic tomography of the upper abdominal organs is sometimes limited by bones and gas. Endoscopic ultrasonography (EUST) combines the advantages of the direct visualization of the upper GI tube and the ultrasonic imaging of adjacent organs. The ultrasonic probe consists of a 5 MHz array that generates a good resolution at the acustical focus, the endoscope is a conventional Olympus gastroscope type GFB3. The ultrasonic transducer is firmly attached to the distal end of the endoscope. Combined examinations are performed in 18 patients with biliary, pancreatic and hepatic disorders or postoperative changes. EUST may be of value not only for gastrointestinal but also for retroperitoneal, cardiac, and mediastinal diseases.

Adult↗
PubMed1980

[Longterm controls after endoscopic papillotomy [EPT] (author's transl)].

In 117 patients who have undergone endoscopic papillotomy (EPT) long term controls have been done. 51 were controlled in the hospital and 66 did answer a questionnaire. The mean time interval to the EPT was mean = 21.6 months. Nine out of every ten patients had no complaints. One third had minimal changes of laboratory dates, which can easily be explained by second diseases. With nearly no exception there was a large orifice to the common bile duct at the upper brim of the papilla. There was no bilioduodenal pressure gradient in 75%. Duodenobiliary reflux could be demonstrated in 25% and aerobilia in 65%. Although there was a massive bacteriobilia in all cases, no signs of cholangitis could be found in any patient. As a result, no unfavourable effects of the EPT became obvious during this follow-up study.

Aged↗
PubMed1979

Enteropancreatic circulation of trypsin in man.

Following the intraduodenal installation of purified 125I-labeled human trypsin up to about 4--6% of the label was measured after 15--30 min in blood plasma and found to separate in a dextran-gel filtration system similar to purified human trypsin (-125I) after incubation with human serum. About 1% of the installed trypsin-(-125I)-dose was found already after 20 min in 100 ml of aspirated pancreatic secretion and later on also in the duodenal content. The results support the concept of the existence of an enteropancreatic circulation of trypsin also in man and explain in part the low to non-detectable levels of immunoreactive serum trypsin observed in patients with exocrine pancreatic insufficiency.

Humans↗
PubMed1979

[Proctitis].

Explore the source record for details and available documents.

Humans↗
PubMed1979

[Therapeutic endoscopy in the gastrointestinal tract].

In selected chapters of the therapeutic endoscopy we tried to represent secure knowledge, actual tendencies and partly future prognoses. Hereby completeness cannot be expected. However, it became clear that numerous physical principles became useful for the therapy with the endoscope. Chemical techniques, such as the litholysis of gall-stones are only at present used in our field. With all scepticism against the own field of interest one may say that the operative therapeutic endoscopy, as it is seen at the instance of the classification of polyps, has led to an improvement of the diagnostics, Its advantages in the therapeutic field are based on the fact that it substitutes larger operations. In the polypectomy- the intervention, avoiding laparotomy and colotomy, is reduced on the minimum given by the size of the polyp. The risk of endoscopic operations is small, compared with the alternative surgical interventions. Shortening of the duration of the disease and hospitalisation leads to lower expenses. Methods, such as the endoscopic haemostypsis or the obliteration of the pancreatic duct, need further detailed examinations. There is no doubt that the modern endoscopy has a strong technical fascination for many young physicians. It gets the greatest value in the hands of a clinically experienced physician.

Cholelithiasis↗
PubMed1979

[A comparison of percutaneous transhepatic cholangiography and endoscopic retrograde cholangiopancreatography (author's transl)].

Results of percutaneous transhepatic cholangiography (PTC) with the Chiba needle were compared with those obtained by endoscopic retrograde cholangiopancreatography (ERCP). PTC was used in 102 cases, most often after ERCP had been inconclusive or had failed. Overall success rate of PTC was 79%. Contrast medium could be injected in only 66% of cases with normal-sized bile passages, but in 98% of those with enlarged passages. The most frequent side effect was temporary pain in the right upper abdominal quadrant. One patient had transitory severe peritoneal irritation with shock. Emergency operation was never required. PTC is technically simpler, takes less time and causes less stress to the patient, but it is less informative than ERCP. If, therefore, both methods are mastered technically, ERCP should be employed first. If it fails to provide the diagnosis, PTC can be performed at once. Biliojejunal anastomoses and pancreatic pseudocysts are absolute indications for the primary use of PTC to investigate the cause of biliary stasis. On the other hand, allergies to iodine or contrast medium and disorders of coagulation are absolute indications for ERCP.

Adult↗