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Biomedical subjects

P Born

Publications and source records attributed to P Born.

69 records · Page 4Linked to original sources
PubMed1991

[Secondary aorto-duodenal fistulas as a cause of massive gastrointestinal hemorrhages].

Aorto-duodenal fistulas represent a rare but highly dangerous complication following reconstructive aortic interventions. They may be the source of severe gastrointestinal hemorrhages. The recognition of cause and localization of the latter may be difficult. Only an immediate diagnosis permits urgent surgical intervention and may prevent the otherwise fatal outcome. The importance of an early diagnosis is underlined by two case reports.

Aged↗
PubMed1989

[Gangliocytic paraganglioma of the duodenum].

In a 49-year-old patient who was investigated because of abdominal complaints we found a polypoid tumor in duodenum near the papilla of Vater. The histological investigation after endoscopical polypectomy showed the rare case of a gangliocytic paraganglioma. After complete endoscopical removal no further intervention is necessary.

Duodenal Neoplasms↗
PubMed1986

Antibody determination in an ongoing hepatitis B vaccination program.

In an interim analysis of our ongoing immunization program against hepatitis B (HB), started in early 1982, we tested 283 serum samples from 77 female and 110 male vaccinees for antibody to HB surface antigen (anti-HBs). We compared two methods, Anti-HBs EIA (ROCHE) (method 1), which is a neutralization test, and AUSABR EIA (method 2), which is a double-antigen-sandwich test. The nonresponder rate (after the 12-month booster dose of Hevac B Pasteur) was 4% in females with both methods, in males 15% measured with method 1 and 11% measured with method 2. Five healthy HBsAg carriers were detected only by method 1. When the samples were grouped according to their anti-HBs titers, method 1 measured higher in samples taken after three vaccine doses and method 2 did so in samples collected after the 12-month booster dose. This tendency was confirmed with samples from slow responders who received a 4th vaccine dose soon after the initial three doses. We therefore confirm the efficacy of the plasma-derived HBsAg vaccine and validate the assay systems used to measure anti-HBs, one parameter of immunity to HB virus infection.

Adult↗
PubMed1985

[Bone scintigraphy in multiple myeloma].

The results of bone scintigraphy were compared with those of plain skeletal X-rays in 26 patients with multiple myeloma who all presented radiological and/or scintigraphic skeletal lesions. 364 bone sites were studied: 135 of them were abnormal, 64 on the plain X-ray alone, 21 on scintigraphy alone and 50 on both examinations. The sensitivity of the bone scintigraphy was only greater than that of plain X-rays for the thoracic lesions (sternum and ribs). The skeletal lesions detected by scintigraphy in addition to those detected on the X-ray would have changed the clinical staging of the patient in only 3 cases. Purely lytic lesions of the thoraco-lumbar spine were never detected by bone scintigraphy. More than one third of the compression fractures were also missed by this examination. The radiological course of 13 sites initially abnormal only on the bone scintigraphy was followed for 6 to 24 months; after this period of time, 9 of these lesions were still radiologically normal. In 6 patients, the radiographic and scintigraphic course could be compared to the clinical and laboratory data on 14 occasions: both pain X-rays and scintigraphy were only concordant with the clinical and laboratory course in no more than one half of cases. The number of abnormal sites on scintigraphy was no different in the patients who responded to treatment. In multiple myeloma, bone scintigraphy only detects a little more than half of the skeletal lesions. When performed in addition to plain X-rays, it detects about 16 per cent of additional lesions, particularly in the ribs and sternum.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Reduced levels of coagulation factor XIII in patients with advanced tumor disease.

BACKGROUND/AIMS: Coagulation factor XIII, which induces the stabilization of fibrin the final step in the coagulation cascade, has various physiological effects. Among these, its beneficial effect in gastrointestinal bleeding episodes is well known. With the exception of inflammatory bowel disease, however, few data are available about this effect, particularly with regard to its role in diffuse bleeding in tumor patients. The study was designed to carry out prospective follow-up investigations, gathering data concerning factor XIII levels in patients with advanced gastrointestinal tumors and evaluating the course of the disease as well as the incidence of bleeding. METHODOLOGY: Sixty patients (22 women, 38 men; median age: 60; range: 29-79) with advanced gastrointestinal tumors were followed-up prospectively. Factor XIII levels were measured using chromogenic substrate. The correlation between the FXIII level and the patients' survival was analyzed using the Cox model. RESULTS: Factor XIII deficiency (below 70%) was seen in only 7 patients (11.6%), 6 of whom died within a median of 1.5 months after the measurement. In all patients however, there was a significant correlation (P = 0.0133) between FXIII levels and the risk of death. Four bleeding episodes occurred in 3 patients, three times with FXIII levels being below the lower normal range. When substitution was attempted, it was only successful in 1 patient in whom the FXIII level was reduced. CONCLUSIONS: FXIII may have predictive value as a marker for the prognosis in these patients with advanced tumor disease. Bleeding episodes were rarely seen, but when they do occur they may be associated with reduced levels of FXIII, and substitution may be beneficial as an adjunct or even as the sole therapeutic intervention.

Adult↗
PubMedDate not supplied

Long-term follow-up of endoscopic therapy in patients with post-surgical biliary leakage.

BACKGROUND/AIMS: Leakage is a rare complication of biliary surgery which is thought to follow a benign course after appropriate treatment. However there is a paucity of long-term follow-up data. PATIENTS AND METHODS: In this retrospective analysis, we present our experience with 21 patients in whom a biliary leakage was diagnosed following conventional and laparoscopic cholecystectomy (n = 14) or other types of biliary surgeries such as liver transplantation or segmental liver resection. Long-term follow-up (mean: 15.5 months) was obtained by telephone contact with patients, families or referring physicians. RESULTS: Endoscopic therapy was primarily successful in 20 of 21 patients and failed in 1 case with complete common bile duct dissection. Closure of the leakage was achieved by placement of nasobiliary tubes or endoprostheses with (n = 16) or without (n = 4) endoscopic papillotomy. Despite successful endoscopic therapy 3 patients died, 1 unrelated to the intervention, and 2 due to prolonged biliary sepsis (mortality: 9.5%; 30 day: 4.8%). Long-term follow-up in the surviving 18 patients showed them to be free of biliary complaints. CONCLUSION: ERCP is the primary modality to diagnose and treat post-operative biliary leakages. Despite rapid healing of the leakage in all 20 successfully treated cases, complications-related mortality was higher than previously suspected.

Adult↗
PubMedDate not supplied

Colonic bacterial activity determines the symptoms in people with fructose-malabsorption.

BACKGROUND/AIM: This study was performed to find a parameter to discriminate symptomatic from asymptomatic subjects with fructose-malabsorption. PATIENTS AND METHODS: Thirty-four subjects (12 m, 22 f; average age, 28.6 years; range 16-60) were investigated after an overnight fast. After intake of 25 g fructose, H2-tests were carried out. Endexspiratory breath samples were taken before the ingestion of the tested sugar and at 30 minute intervals over a 2 hour period. Hydrogen determination was performed immediately after sampling. Results were considered pathological if there was a rise in hydrogen over 20 ppm and a twofold increase from the initial value. Aerobic and anaerobic cultures from stool bacteria were set and incubated with 0.5 g fructose. RESULTS: Among 34 healthy controls, 13 malabsorbers (38%) were detected. Out of these malabsorbers, 6 (46%) reported gastrointestinal concomitant symptoms. Symptomatic and asymptomatic subjects with fructose-malabsorption showed a comparable increase in hydrogen levels. The disappearance rate of fructose in the stool cultures was significantly elevated in the symptomatic group compared with the asymptomatic, but only in the anaerobic culture. CONCLUSION: This activity of colonic bacteria, significantly discriminating symptomatic subjects with fructose-malabsorption from asymptomatic, enhances the importance of fructose-malabsorption in the differential diagnosis of people with non-specific abdominal complaints. Antibiotic therapy in severe cases should be considered a therapeutical approach. Moreover these results may support the role of nutritional carbohydrates in the pathogenesis of colonic diseases.

Adult↗
PubMedDate not supplied

Long-term results of endoscopic treatment of biliary duct obstruction due to pancreatic disease.

BACKGROUND/AIMS: Endoscopic stenting has become an established method of providing palliative treatment in cases of malignant biliary obstruction, as well as in benign biliary stenosis. Several problems associated with the types of stent used have not yet been resolved, and an ideal stent has yet to be designed. Observation of the clinical course for patients with biliary obstruction of various etiologies, and evaluation of the results with various treatment methods are the aims of this study. METHODOLOGY: In 1993 and 1994, biliary obstruction was treated endoscopically in 47 patients with a malignant pancreatic tumor and in 18 patients with chronic pancreatitis. The primary intervention was assessed retrospectively on the basis of the patients' records, and information concerning the clinical course was obtained by contacting the patients or their relatives or general practitioners. RESULTS: Primary endoscopic drainage was successful in all cases. Only one of the patients with pancreatic tumors is still alive; survival after stent placement averaged 6.2 months. Metal stents remained patent significantly longer than plastic stents and percutaneous transhepatic biliary drains (PTBDs)(8.2 versus 3.5 or 1.9 months; p < 0.001). In cases of chronic pancreatitis, three of the nine patients who received only endoscopic treatment, without stenting, were able to continue without stents in the longer term, whereas seven of the nine who underwent surgery had no further problems. CONCLUSIONS: Endoscopic drainage of biliary obstruction provides excellent short-term results. In long-term treatment for purely palliative purposes, metal stents remain patent for longer than plastic stents. In chronic pancreatitis, surgical treatment clearly seems to provide better long-term results than endoscopic therapy.

Adult↗