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Biomedical subjects

M Staritz

Publications and source records attributed to M Staritz.

At least 73 records · Page 4Linked to original sources

[Effect of glycylpressin on pressure in esophageal varices in patients with liver cirrhosis and previous hemorrhaging varices].

In 15 patients with the history of bleeding from esophageal varices, confirmed cirrhosis of the liver (Child A) and esophageal varices (grade II, 2; grade III, 11; and grade IV, 2 patients) esophageal intravariceal pressures were endoscopically measured before and 10 min after intravenous administration of 1 mg glycylpressin. Pressures fell in the patients without previous sclerotherapy from 21.8 +/- 2.8 to 19.0 +/- 1.9 mm Hg (not significant), in those previously sclerosed from 18.0 +/- 1.4 to 14.5 +/- 1.0 mm Hg (p less than 0.05). In two of the non-sclerosed patients and one after sclerotherapy no change of pressure was recorded. The results indicate that glycylpressin has a relatively minor and uncertain effect on esophageal intravariceal pressure. In view of the possible side effects of the drug the indications for its use should be carefully weighed.

Adult↗

Characterisation of a new subgroup of autoimmune chronic active hepatitis by autoantibodies against a soluble liver antigen.

Autoantibodies against a soluble liver antigen (SLA) were detected in 23 patients with HBsAg-negative chronic active hepatitis (CAH) but not in 502 patients with various other hepatic and non-hepatic disorders or 165 healthy blood donors. Anti-SLA-positive serum samples were negative for antinuclear and liver-kidney-microsomal antibodies, markers of two subgroups of autoimmune-type CAH, 6 anti-SLA-positive patients were negative for all autoantibodies sought. Most of the anti-SLA-positive patients were young women (2 men, 21 women; mean age 37 years) with hypergammaglobulinaemia (mean 3.2 g/l, range 1.8-5.3 g/l); 18 of the 23 patients had received immunosuppressive treatment and all responded well. Anti-SLA titres declined during therapy, corresponding to disease activity. Anti-SLA cannot be detected by immunofluorescence. SLA is not organ-specific or species-specific, but the highest concentrations were found in liver and kidney. Anti-SLA autoantibodies characterise a third subgroup of autoimmune-type CAH and will allow a better differentiation of HBsAg-negative CAH which has therapeutic consequences.

Adolescent↗

Spontaneous and antibody-dependent cellular immune reactions to ethanol-altered hepatoma cells.

Spontaneous cell-mediated cytotoxicity (SCMC), antibody-dependent cellular cytotoxicity (ADCC) and proliferative lymphocyte stimulation in alcoholic liver disease (ALD) were investigated. Peripheral blood lymphocytes (PBL) from eight patients with advanced ALD and nine normal controls were tested against hepatoma cells (PLC/PRF/5) as targets. Target cells were grown in either normal culture medium or medium supplemented with 1 and 5% ethanol, respectively, for 24 to 48 h. Ethanol-exposed hepatoma cells exhibited profound and characteristic morphological alterations. Ethanol preincubation, however, proved to be without effect on immune reactions. Provided that hepatoma cells are an appropriate model, we assume that the proposed immune reactions in ALD are based on metabolic interactions operative only in vivo but do not parallel morphological alterations of liver cells directly induced by ethanol.

Adult↗

[Myxoma of the right atrium. Rare differential diagnosis of fever of unknown origin].

Cholecystectomy had been performed in a 52-year-old woman because of upper abdominal pain with nausea, fever and accelerated ESR and known cholelithiasis. Attacks of fever up to 39.5 degrees C persisted and she lost 10 kg in weight, requiring re-admission after eight months. Transoesophageal echocardiography revealed an echo-dense space-occupying lesion, 3.0 X 3.5 cm, in the right atrium. Due to contrast medium allergy angiography was omitted. M-mode and 2D echocardiography and computed tomography of the heart failed to demonstrate any space-occupying body. Thoracotomy revealed a fibro-angio-myxoma attached to the right side of the interatrial septum, and it was removed in toto. The postoperative course was without complications and the patient left hospital free of symptoms. It is suggested that transoesophageal echocardiography should be considered in case of "fever of unknown origin".

Diagnosis, Differential↗

[Pancreas divisum: predisposition to chronic pancreatitis caused by chronic secretory stasis? Results of endoscopic intraductal pressure measurements].

In 6 patients with upper abdominal pain of unknown origin presenting with pancreas divisum, the pressure in the pancreatic duct was measured via the minor papilla into which in these patients the main part of the pancreatic duct system drains. For comparison intraductal manometry via the major papilla (papilla of Vater) was performed in 8 patients with normal pancreatic duct system. The pressure in the pancreatic duct of the control group was 10.5 +/- 0.9 (8-14) mm Hg, whereas in the patients with pancreas divisum it was 23.7 +/- 1.3 (20-28) mm Hg. The results demonstrate that in patients with pancreas divisum intraductal pressure may be largely increased even in the fasting state.

Adult↗

Investigation of the sphincter of Oddi before, immediately after and six weeks after endoscopic papillotomy.

The sphincter of Oddi was investigated before, immediately after and 6 weeks after endoscopic sphincterotomy by endoscopic inspection, ERCP manometry, and by X-ray following retrograde cholangiography in 14 patients presenting with bile duct stones. The sphincter motility was normal before sphincterotomy. Following electrocautery no sphincter motility was noted, the sphincter baseline pressure showed considerable interindividual changes, and the length of the residual sphincter seemed to be only slightly reduced from 14.1 mm (before) to 10.9 mm. Despite this fact, bile duct concrements of more than 10 mm in diameter could be extracted without difficulty in all patients, confirming the adequacy of the sphincterotomy. Six weeks after sphincterotomy the sphincter length was 1.9 mm (0 to 7 mm) and in 6 patients the sphincter was completely incompetent, as demonstrated by the bile duct pressure (0 mmHg) and aerocholia, in the remaining 8 patients a small residual sphincter was able to maintain sphincter patency. We conclude that ERCP manometry cannot serve to confirm completeness of sphincterotomy immediately after electrocautery. But it would be possible to perform "semisphincterotomy" by assessing the sphincter length before cutting. Since sphincterotomy causes sphincter incompetence only in some patients, ERCP manometry would be a reliable aid for classifying the patients for follow-up studies.

Aged↗