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M Hartleb

Publications and source records attributed to M Hartleb.

88 records · Page 5Linked to original sources
PubMed1984

Evidence of improvement in deficient gastroenterological diagnosis--a regional experience report.

A similar study carried out in 1964-1975 showed that very low diagnostic efficiency in gastroenterology rose at the end of this period, supposedly due to the introduction of modern techniques. The present study was designed to evaluate the effect of new imaging techniques (computerized tomography, ultrasonography, gammagraphy and ERCP) in the routine diagnostic efficiency in the same department of gastroenterology between 1979-1983. The study was carried out in two series. In the first, 217 clinical diagnoses were compared with the autopsy findings, and 488 with the surgical findings in the second series. Diagnostic efficiency proved to be twice as high as 10 years ago (p less than 0.0005); the highest diagnostic level was attained in the upper digestive tract. The threefold improvement in pancreatic disease diagnosis from 22% in the previous study to about 60% now did not attain the same level of accuracy (p less than 0.001). The success was due to a 50% decrease (p less than 0.0005) in the number of false negative diagnoses, while false positives remained at the same level of about 10%. In contrast to earlier findings no great difference was found between younger and older age groups.

Aged↗
PubMed1983

The bioavailability of three dipyridamole products.

Following oral administration of 75 mg of three dipyridamole commercial products in a three-way crossover design with six subjects, no statistically significant differences were found for serum concentrations at all sampling times nor for bioavailability parameters. The only exception was the higher serum concentration occurring 0.5 h after administration of Antistenocardin when compared with dipyridamole (p less than 0.05).

Administration, Oral↗
PubMedDate not supplied

Neurogenic tumors of the digestive tract: report of two cases.

We report two female patients with neurogenic tumors of the digestive tract. In the first patient, the tumor of 10 cm diameter originated in the stomach and at preoperative CT imitated a peripancreatic cyst. In the second patient, the tumor of 6 cm diameter originated in the duodenum. Despite large size, the tumors were clinically indolent and escaped detection at routine endoscopic evaluation. In both cases the neoplasm was removed and postoperative histopathology combined with immunohistochemistry was consistent with diagnosis of digestive Schwannoma.

Aged↗
PubMedDate not supplied

Clinical utility of quantitative assessment of liver haemodynamics in cirrhosis provided by dynamic hepatoscintigraphy.

Interrelationships between quantitative assessment of portal (%Qp) and arterial (%Qa) components of hepatic blood supply obtained by dynamic hepatoscintigraphy, and clinical variables characterizing the severity of liver cirrhosis and portal hypertension were studied in 25 cirrhotic patients. The variables, clinical state, size of oesophageal varices, ascites accumulation, sonographic stigmata of portal hypertension, liver mass and elimination rate of lidocaine and antipyrine were studied. The %Qa rose in proportion to the severity of liver injury estimated from the Child-Turcotte and McCormick grading scores. The mean %Qa for patients with Child A cirrhosis was significantly higher than that for 8 healthy subjects (34.8 +/- 7.9% vs 18.1 +/- 4.0; P < 0.01). The %Qp values showed relationship with the size of esophageal varices, provided discriminatory data with respect to the ascitic fluid accumulation and the development of intraabdominal collateral circulation. The liver mass had no impact on hepatic dual blood supply pattern, but was linked with the rate of antipyrine clearance. Neither antipyrine clearance nor lidocaine elimination rate corresponded to alterations of hepatic dual blood supply. The %Qp showed a negative correlation with the initial half-life of lidocaine, which was referred to lowered hepatic uptake of the drug. It is concluded that the quantitative assessment of %Qp and %Qa reflect the advancement of portal hypertension better than liver function failure does.

Adult↗
PubMedDate not supplied

[Highly differentiated cancer or adenoma of the liver: diagnostic approach in highly differentiated epithelial tumors of the liver].

High-differentiated hepatocellular carcinoma (h-d HCC) is a not frequent hepatic tumour but its outcome may be beneficial when treated properly. Two cases of h-d HCC recognized on the basis of postoperative histopathology are reported. We have discussed the role of fine needle biopsy in distinguishing h-d HCC from liver adenoma, and we have attempted to outline the diagnostic approach in clinically silent hepatic tumours which are not associated with cirrhosis or elevated alfa-fetoprotein plasma level.

Adenoma↗
PubMedDate not supplied

[Static and dynamic scintigraphy of the liver using labeled erythrocytes in the diagnosis of hepatic hemangioma].

In order to find hemodynamic differences between hemangioma (n = 10) and other tumours of the liver (n = 15) dynamic angioscintigraphy and late vascular scintigraphy of the liver were performed. Late vascular scintigraphy has revealed focal cumulation of the labelled erythrocytes in 7 hemangiomas of the diameter of 35 mm, 3 hemangiomas below this size have not been diagnosed with this technique. Beside hemangiomas, a focus of erythrocytes cumulation was found also in the hepatocellular adenoma. Arterial blood supply to hemangioma was significantly higher, than that in the malignant tumours of the liver (54.6% vs 31.7%). Other parameters of the early phase of angioscintigraphy have no diagnostic value in the differentiating the hepatic tumours. Vascular scintigraphy of the liver proved to be a valuable technique in the diagnosis of large hemangiomas only.

Adult↗
PubMedDate not supplied

The theophylline disposition after caffeine administration in liver cirrhosis: an index of liver function.

Six blood samples covering a 24 hr post caffeine dosage were drawn in 8 healthy subjects and 18 patients with liver cirrhosis. Caffeine and theophylline concentration were assayed by gas-chromatography and fluorescent polarization immunoassay, respectively. In normals the maximum theophylline levels were found between 3 and 8 hrs (62.5% at 8 hrs) and ranged 50-420 ng/ml, whereas these levels in cirrhotic patients were noted between 3 and 12 hrs (61.1% at 8 hrs) and ranged 40-670 ng/ml. The largest difference in mean theophylline concentration between normals and cirrhotics was found at 6 hrs (348 +/- 103.7 ng/ml vs 217.1 +/- 140.8 ng/ml; p less than 0.02) and 24 hrs (101.6 +/- 57.3 ng/ml vs 172.2 +/- 119.6 ng/ml; p = 0.075) after caffeine dosing. Theophylline formation rate (theo6) differentiated controls from cirrhotics in the initial stage of the disease (Child-Pugh A), however it failed to discriminate between initial and late cirrhosis. In contrast, the ability of liver to remove theophylline (theo24) differentiated effectively these groups of patients. Theo6 to theo24 ratio was a valuable index of liver function, although its capacity to detect early cirrhosis was unsatisfactory.

Adult↗
PubMedDate not supplied

Non-endoscopic diagnosis of multifocal atrophic gastritis; efficacy of serum gastrin-17, pepsinogens and Helicobacter pylori antibodies.

BACKGROUND/AIMS: Infection with H. pylori is an important risk factor for the development of gastric cancer and glandular atrophy is an intermediate stage in gastric carcinogenesis. While screening the patients with atrophic gastritis by endoscopy is unrealistic, a concept of "serological gastric biopsy" based on measurement of gastric secretory proteins and peptides should be further validated. We sought to determine if the laboratory panel composed of serum PGI and protein stimulated gastrin-17 might select patients with MAG, and what is diagnostic significance of H. pylori serology in population of high prevalence of H. pylori infection. MATERIAL AND METHODS: 55 consecutive patients of both sexes (M/F 25/30; range of age 55 -81 years) were referred for gastroscopy with antrum and corpus mucosal biopsies. Patients with histological signs of glandular atrophy at any site of the stomach were considered to have multifocal atrophic gastritis. A first blood sample was collected for measurement of basal gastrin-17, pepsinogens and H. pylori IgG-antibodies, and second was taken 20 minutes after use of protein-rich drink to measure stimulated gastrin-17. RESULTS: Signs of mucosal atrophy were found in 19 patients, while 29 patients showed non-atrophic gastritis and seven H. pylori-negative patients had no histological pathology. Low serum level of stimulated gastrin-17 (< 5 pmol/l) and/or pepsinogen I (< 50 microg/l), were found in 16 of 19 patients (84.2%) with and in 7 of 36 patients (19.4%) without atrophy in the histological study. Combining of H. pylori serology with serum levels of secretory peptides had no significant effect on diagnostic sensitivity of the test panel. CONCLUSION: The test panel composed of pepsinogen I and protein stimulated gastrin-17 may be used as the "serological gastric biopsy" detecting multifocal atrophic gastritis. The diagnostic sensitivity of this test panel is not increased by knowledge of H. pylori status.

Aged↗
PubMedDate not supplied

[Diagnostic difficulties in prajmaline-induced intrahepatic cholestasis].

A case of prajmalium-induced intrahepatic cholestasis is presented. A proper diagnosis was delayed because differential diagnosis did not include toxic liver damage. Pathogenetic considerations included immunological background of the disease which improved completely within one year. No clinical and biochemical complications were seen.

Arrhythmias, Cardiac↗
PubMedDate not supplied

The role of nitric oxide in portal hypertensive systemic and portal vascular pathology.

Hypotension, low systemic vascular resistance and reduced sensitivity to vasoconstrictor are features of hyperdynamic syndrome in portal hypertension (PH) and are pathogenetic factors triggering most serious clinical complications of liver cirrhosis. Nitric oxide (NO) is a powerful vasodilating agent, released from vascular endothelium cell and effecting relaxation of vascular smooth muscle. An increased release of NO has been proposed to play a role in the pathogenesis of vasodilation and vascular hypocontractility associated with PH. In agreement with this hypothesis, the whole-body production of NO has been found to be increased in PH, and the measurement of NOS mRNA expression in different organs suggest that the splanchnic vascular system is a major source of NO release. Consequently, NO could play a role in the development of the splanchnic hyperaemia, collateral circulation and portal hypertensive gastropathy. Furthermore, increased generation of NO in central circulation likely accounts for pulmonary vasorelaxation and cardiac dysfunction found in cirrhosis. By contrast, PH-associated endothelial dysfunction seems to invalidate the capability of intrahepatic and intrarenal vasculature to produce NO. A deficient NO release in these vascular territories might contribute to enhancement of PH and development of the hepatorenal syndrome. Overall NO hyperproduction is either the cause (induction of iNOS) or the consequence (stimulation of ecNOS) of the hyperdynamic syndrome. This incertitude results from the yet undefined significance of mild and transitory activation of the endotoxin-cytokines axis for iNOS induction and contradictory data on specific iNOS and ecNOS activities. A contribution of each isoform of NOS to pathogenesis of the hyperdynamic syndrome probably depends on the model of PH in animal studies and the aetiology or severity of cirrhosis in human studies.

Animals↗