Search PubMed⌕ Search

Biomedical subjects

M Cremer

Publications and source records attributed to M Cremer.

At least 127 records · Page 7Linked to original sources
PubMed1990

[Lack of predictive factors for symptomatic recurrence of Crohn disease at the site of surgical anastomosis].

Recurrence of Crohn's disease at the ileocolonic anastomosis after curative surgery is frequent. Prognostic value of several parameters at the time of surgery was studied in 37 patients to detect early symptomatic recurrence of Crohn's disease after surgery. These included patient age at the time of surgery, sex, disease duration before surgery, clinical activity index, length of resected bowel, presence of granulomas in resected bowel segment, indication for surgery, type of medical treatment before surgery, and biochemical parameters at the time of surgery (ESR, C reactive protein and serum albumin level). Symptomatic recurrence associated with endoscopic lesions at the anastomotic site was observed in 10 of 37 patients (27 percent), within one year after surgery. None of the studied parameters were able to differentiate the patients with recurrence or not.

Adolescent↗
PubMed1989

Detection of Duchenne muscular dystrophy carriers by dosage analysis using the DMD cDNA clone 8.

Deletion screening in 11 unrelated DMD patients has been performed using DMD cDNA clones 1-8. Of these 11 patients, 6 exhibit deletions of the cDNA clone 8. The carriership of 18 female relatives from these six DMD families has been investigated by dosage analysis. It is shown that dosage analysis is an available method to determine the carrier status of the female relatives of DMD patients showing a deletion within a DMD cDNA clone.

Chromosome Deletion↗
PubMed1989

Endoscopic ultrasonography in achalasia.

Six patients with known achalasia were examined by endoscopic ultrasonography before dilatation therapy. At the level of the lower esophageal sphincter, a typical enlargement of the echolayer corresponding to the muscularis propria was observed in 5 cases. Endoscopic ultrasonography is a complementary procedure to manometry and x-ray for diagnosing achalasia. It helps differentiate achalasia from pseudoachalasia. In pseudoachalasia there is tumor infiltration.

Adult↗
PubMed1989

Postendoscopic sphincterotomy stenosis.

We report on two patients. The first patient is a 62-year-old female patient who had cholecystectomy in 1970, and in whom two small bile duct stones were removed after endoscopic sphincterotomy in 1987. Within two months of this procedure, she developed three episodes of documented acute pancreatitis. The other patient, a 58-year-old female, developed acute pancreatitis three months after an endoscopic sphincterotomy for stones in the common bile duct. In both patients, ERCP revealed a cicatricial stenosis of the common bile duct and the pancreatic duct. The condition was resolved by repeat sphincterotomy. The first patient needed repeated endoscopic insertion of bilioduodenal endoprostheses and an endoprosthesis in the pancreatic duct. It is interesting to note that, in contrast to surgical reports, very few postpapillotomy stenoses are reported by endoscopists.

Common Bile Duct Diseases↗
PubMed1989

Occluded pancreatic endoprostheses--analysis of the clogging material.

One of the most common late complications of transpapillary pancreatic endoprostheses is clogging of the endoprosthesis lumen. In this study we analysed the morphology and the biochemical nature of the contents of 10 clogged pancreatic endoprostheses. At the optical level the sludge presented as an organic matrix with embedded small quantities of CaCO3 crystals (and in one case CaCO3 microcalculi). Electron microscopy showed the presence of bacterial ghosts and protein threads. The characteristic pattern of proteolysed pancreatic proteins was obtained when the organic matrix was analysed by SDS-Page. The presence of trypsinogen, amylase and one of the molecular secretory forms of Pancreatic Stone Protein (PSP) was confirmed by Western-blotting. PSP was also found in association with CaCO3 crystals by immunolocalization. These results suggest that endoprosthesis clogging is due to the precipitation of whole pancreatic juice protein, probably triggered by uncontrolled proenzyme activation.

Amylases↗
PubMed1989

Methods of disinfecting endoscopic material: results of an international survey.

A questionnaire on the methods of cleaning and disinfecting endoscopic equipment was mailed to 120 centers in Western Europe. Seventy-four questionnaires (61%) were returned. The centers were classified into three groups according to the number of endoscopic procedures performed per year. This survey has shown that precautions are more rigid in specialized centers than in units doing fewer than 1,500 endoscopic investigations a year. Complete disinfection is done by almost all the centers after ERCP in infected patients or in the case of HBsAg and HIV-positive patients, but only by 70% of centers after completion of endoscopies performed in patients with gastrointestinal hemorrhage and unknown immunological status. After endoscopic examination performed in presumably non-infected subjects, complete disinfection is not done in any center after gastroscopy, in 13% after colonoscopy and in 30% after ERCP. Continued education of endoscopic personnel and greater availability of adequate endoscopic equipment is mandatory for minimizing the risk of endoscopy-related infections.

Disinfection↗
PubMed1989

[Parenteral nutrition at home: 2 years' experience].

Home parenteral nutrition (HPN) must be reserved for patients with an dysfunctional bowel requiring a long-term nutritional support. We report a 2 year experience of HPN at Erasmus Hospital which includes seven patients. Indications and implications of HPN are also discussed.

Crohn Disease↗
PubMed1989

Pancreaticoduodenal resection for pancreatic or periampullary tumors--a ten-year experience.

Between January 1978, and December 1987, 79 patients underwent pancreaticoduodenal resection for pancreatic (44) or periampullary tumors (ampulla 18, common bile duct 9, duodenum 8). Fifty-five patients were icteric (55/79: 70%); 33 of them underwent preoperative biliary decompression (endoscopic procedures 29, percutaneous transhepatic drainage 3, laparotomy and T-tube placement. 1) After biliary drainage, bilirubin levels decreased from 12.4 +/- 1.3 mg/dl at admission to 5.1 +/- 1.1 mg/dl before surgery. Pancreaticoduodenal resection was performed within a mean of 15 +/- 13 days after biliary decompression. Twenty-seven patients had no complications, others developed one or more complications. The postoperative mortality was 5% (4/79). The influence of various clinical, biological and pathological factors on postoperative complications and long-term survival was studied. Neither jaundice nor preoperative biliary drainage had a statistically significant effect on overall morbidity and mortality. However, septic and hemorrhagic complications appeared to be more frequent with preoperative bilirubin levels above 20 mg/dl (0.05 less than P less than 0.1), while all postoperative pancreatic and biliary fistulas occurred in patients with a bilirubin level below 6 mg/dl (P less than 0.01). Biliary fistulas were also more frequent when anastomosis was performed on a non-dilated biliary duct (P less than 0.05). Overall actuarial survival was 58% at 1 year and 26% at 5 years. Node and/or contiguous tissue infiltration significantly decreased long-term survival (P less than 0.001). Seventy-one adenocarcinomas were reviewed and graded following a modified version of Klöppel's pathological classification.(ABSTRACT TRUNCATED AT 250 WORDS)

Ampulla of Vater↗
PubMed1988

Immune status in healthy relatives of patients with familial Crohn's disease.

Immune-mediated mechanisms and genetic factors are believed to be involved in the pathogenesis of Crohn's disease. We studied T- and B-cell subpopulation proportions and various functional assays, including proliferative responses to PHA and Con A, Con A-induced suppressive activity, and natural killer cell assay toward the K562 cell line, in the peripheral blood of 22 patients with inactive familial Crohn's disease and their 35 healthy relatives including nine families. HLA-A, -B, and -DR antigens were determined in all the subjects. With the exception of minor abnormalities of suppressor cell activity present in some relatives of two families, neither significant impairments of immunological parameters in patients or their relatives nor concordant segregation of HLA haplotypes and disease were observed. These data indicate that peripheral immune abnormalities previously described in patients with Crohn's disease do not constitute primary factors involved in the disease itself and that familial incidence in Crohn's disease cannot be linked to immunological markers presently studied.

Adolescent↗
PubMed1988

[Appendicular mucoid impaction disclosing mucoviscidosis with cirrhosis in a young adult without pulmonary lesion].

A 22-year-old man presented with pain in the right iliac fossa. Clinical examination suggested appendicitis and showed splenomegaly. Echography and abdominal CT-sca suggested the diagnosis of cystic fibrosis based on the association of signs of cirrhosis and pancreatic atrophy. The sweat test was positive. The hypothesis of a mucoid appendicular impaction with spontaneous regression was retained based on clinical and radiological signs. This atypical presentation of cystic fibrosis underscores the frequency of obstructive intestinal which occasionally reveals the disease in the adult, and on the absence in this case of otherwise frequently associated problems such as significant pulmonary disease and malnutrition.

Adult↗
PubMed1987

Acute pancreatitis as presenting symptom and sole manifestation of small cell lung carcinoma.

A 58-year-old man with no sign of pulmonary disease and a normal chest x-ray presented with acute pancreatitis resistant to conventional medical management and a mass in the head of the pancreas. The presumptive diagnosis was pancreatic cancer with tumor-induced pancreatitis. However, endoscopic retrograde cholangiopancreatography suggested metastatic rather than primary tumor, so that an extrapancreatic primary was actively sought. Further lung work-up demonstrated a small cell carcinoma of the lung. This case indicates that metastasis-induced acute pancreatitis can be the presenting symptom and sole manifestation of lung cancer.

Acute Disease↗