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Biomedical subjects

M Classen

Publications and source records attributed to M Classen.

At least 397 records · Page 22Linked to original sources
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↗
PubMed1978

[Crohn's disease: course and prognosis in 169 patients (author's transl)].

The most common initial symptoms in 169 patients with Crohn's disease, followed from 1956 to 1973, were diffuse abdominal pain, diarrhoea without any blood admixture, loss of weight, and fever. At the onset of the disease 84% of patients were aged 10-39 years. The most important complications (in descending order of frequency) were fistulae and abscesses, ileus, anaemia, and malabsorption. A breakdown into active and passive phases indicated that the younger the patient at onset of the disease, the more severe its course. The disease seemed to take a more favourable course when only the colon, but not the terminal ileum, was involved. Recurrence occurred more frequently after a short than after a long preoperative history. Recurrences were more frequent in patients under than over 31 years of age at their first operation.

Adolescent↗
PubMed1978

Santorini's Duct--an insignificant variant from normal or an important overflow valve?

In a retrospective examination 250 consecutive pancreatograms obtained by ERCP were controlled on the existence of a D. Snatorini. Starting from the genetic development of the pancreatic ducts the question is investigated whether a second open pancreatic duct is responsible for a better drainage of the pancreas. Thus this duct may prevent hyperamylasemia and hyperlipasemia following ERCP. From an etiological point of view the elevation of these pancreatic enzymes is insufficiently understandable. If a D. Santorini is detectable the results demonstrate a reduction of the increased pancreatic enzymes in a statistically significant manner. A valve mechanism of the D. pancreaticus minor with volume or pressure reduction is postulated.

Amylases↗
PubMed1978

Gas sterilization of fiber endoscopes.

Excitants of disease can be transmitted by endoscopes from one patient to another. Owing to their complicated construction and the heat-sensitive material fiber glass endoscopes are difficult to disinfect or sterilize. Of the known procedures of sterilization only gas sterilization with ethylene oxide can be used. Clinical examinations and laboratory experiments demonstrate the reliable efficacy of this procedure of sterilization of fiber glass endoscopes. On account of known risks the indications for gas sterilization are compiled.

Bacteria↗
PubMed1978

Descending sphincterotomy of the papilla of Vater through the T-drain under endoscopic view. Variants of endoscopic papillotomy (EPT).

An indwelling T-drain is a valuable access to the common bile duct if the conventional EPT fails in the case of choledocholithiasis. It is often easier to cannulate the duodenal papilla from the common bile duct than from the duodenum. A papillotome of the Erlangen type introduced through the T-drain into the papilla spontaneously has the correct cutting direction. The incision is controlled endoscopically. If a patient has undergone Billroth II operation, the particularly difficult cannulation and incision of the papilla is make much easier by the descending technique. Two variants of the endoscopically controlled descending electropapillotomy were successfully performed.

Aged↗
PubMed1977

[Colonic tumors].

Explore the source record for details and available documents.

Colonic Neoplasms↗
PubMed1977

[Diagnostic methods in the bulbus duodeni. Agreement and disagreement between endoscopic, roentgenological and histological examinations (author's transl)].

In a collective of 1012 patients (700 m., 312 f.), 346 (268 m., 78 f.) had pathological endoscopic findings in the bulbus. Diseases of the bulbus appeared in women about 10 years later than in men. In comparison to the endoscopic findings, roentgen findings showed disagreement in about 35% which mainly arose from contradictions in the assessment of cicatricial changes in the bulbus. False negative ulcer findings amounted to about 21%, the false positive to 19%. Endoscopic and histologically confirmed malignancies were not overlooked in a single case.

Adult↗
PubMed1977

[Diagnostic Methods in the Bulbus Duodeni. Agreement and Disagreement between Endoscopic, Roentgenological and Histological Examination (author's transl)].

In a collective of 1012 patients (700 m., 312f.), 346 (268 m., 78 f.) had pathological endoscopic findings in the bulbus. Diseases of the bulbus appeared in women about 10 years later than in men. In comparison to the endoscopic findings, roentgen findings showed disagreement in about 35% which mainly arose from contradictions in the assessment of cicatricial changes in the bulbus. False negative ulcer findings amounted to about 21%, the false positive to 19%. Endoscopic and histologically confirmed malignancies were not overlooked in a single case.

Diagnosis, Differential↗
PubMed1977

[Retrograde endoscopic diagnosis and therapy in diseases of the bile papillae and the bile ducts (author's transl)].

Duodenoscopy with retrograde cholangiopancreatography including associated methods (cytology, manometry, endoscopic sphincterotomy, etc.) allows, with little risk, a more precise differentiation of jaundice. Considering the therapeutic consequences, the effort seems relatively small. Diagnostic improvements lead to more differentiated therapy. Therapeutic endoscopy is being substituted for classic therapeutic methods of internal medicine and surgery.

Biliary Tract Diseases↗