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Biomedical subjects

P Matzen

Publications and source records attributed to P Matzen.

At least 91 records · Page 5Linked to original sources
PubMed1983

Ultrasonography, computed tomography, and cholescintigraphy in suspected obstructive jaundice--a prospective comparative study.

In order to compare their capacity to visualize the bile ducts, ultrasonography, computed tomography, and cholescintigraphy were performed in 56 consecutive jaundiced patients in whom extrahepatic cholestasis was clinically suspected. The predictions as to the patency of the large bill ducts were compared with the final diagnoses made on the basis of direct cholangiography together with autopsy, biopsy, operative findings, and the clinical course. Thirty-nine patients (70%) had obstructed bile ducts, and 17 (30%) had patent large bile ducts. Using a simple scoring scale with 112 points as the maximum, ultrasonography obtained 72 points, computed tomography received 56 points, and cholescintigraphy totalled 37 points. Nonsignificant trends were found in favor of ultrasonography as compared with computed tomography and of computed tomography as compared with cholescintigraphy (p greater than 0.05), whereas ultrasonography was significantly better than cholescintigraphy (p = 0.01). However, because computed tomography is expensive and may imply a higher number of secondary direct cholangiographies than ultrasonography, we recommend ultrasonography as the first choice for noninvasive bile duct visualization. Computed tomography is an alternative method, whereas cholescintigraphy cannot be recommended.

Cholangiography↗
PubMed1982

Prognosis of acute nonspecific abdominal pain. A prospective study.

In a prospective study of 230 patients followed up for 5 years after hospital admission for acute non-specific abdominal pain, 21 patients (9 patients) could not be traced, and 11 (5 percent) had died. Only one death was related to symptoms from the first admission. Of the remaining 198 patients, 77 percent were healthy and free of any symptoms during the observation period. Fourteen patients (7 percent) had been hospitalized once more due to acute abdominal pain; 5 had acute appendicitis. The others had diagnosed recurrences of nonspecific abdominal pain. Sixteen percent complained of continuing of intermittent abdominal symptoms, mainly of benign colonic or gynecologic origin, while malignant disease developed in 1 percent (or 4 percent of patients over 50 years of age). It is concluded that control of these patients is generally unnecessary, but when symptoms recur further examinations, especially for colonic or gynecologic disease, should be carried out. In patients over 50 years old, the possibility of malignant disease should be kept in mind.

Abdomen↗
PubMed1982

Endoscopic retrograde cholangiopancreatography and transhepatic cholangiography in patients with suspected obstructive jaundice. A randomized study.

To establish principles for choosing between endoscopic retrograde and percutaneous transhepatic cholangiography, we randomized 52 consecutive jaundiced patients with clinically suspected obstructive jaundice. The bile ducts were visualized in 85% by the endoscopic and in 84% by the transhepatic route. A conclusive diagnosis was reached in 89% and 68% of the patients, respectively, but the difference is not significant (0.10 less than P less than 0.20). If the planned type of cholangiography failed, the other method was tried. By comparing the total numbers of investigations, a conclusive diagnosis was achieved in 91% by endoscopic and 69% by transhepatic route, which is significantly different (P less than 0.05). We therefore prefer to do endoscopic cholangiography initially with transhepatic cholangiography as the complementary method.

Adult↗
PubMed1982

The role of endoscopic pancreatography in pancreatic ascites.

Pancreatic ascites due to chronic pancreatitis and pancreaticoperitoneal fistula in three patients is reported. The diagnoses were based on amylases in the ascitic fluid. An exact localization of the leakage of pancreatic juice by endoscopic retrograde pancreatography made a rational approach to therapy possible.

Adult↗
PubMed1981

[Antacids].

Explore the source record for details and available documents.

Antacids↗
PubMed1981

Electrophoretic separation of alkaline phosphatase isoenzymes compared with alkaline phosphatase and gamma-glutamyltransferase in hepatobiliary diseases.

Electrophoretic separation of serum alkaline phosphatase fractions and measurement of serum alkaline phosphatase and serum gamma-glutamyltransferase were carried out in 82 consecutive patients with suspected hepatobiliary disease to investigate the usefulness of the three tests in distinguishing between parenchymatous hepatic disease and occlusive hepatobiliary disease. It was concluded that measurement of total serum alkaline phosphatase was superior to the two other tests.

Alkaline Phosphatase↗
PubMed1981

Causes and characteristics of 500 consecutive cases of jaundice.

During approximately 2 years 106 clinical and routine laboratory parameters were obtained from each of 500 jaundiced patients consecutively admitted to the surgical and medical departments in a hospital covering a third of the hospital admissions in the city of Copenhagen. The patients were classified mainly by morphological criteria (397 patients) or the subsequent clinical course (103 patients) into five major diagnostic categories: acute parenchymal jaundice (113 patients), chronic parenchymal jaundice (97 patients), gallstone disease (76 patients), malignant obstructive jaundice (104 patients), and other causes of jaundice (110 patients). The five major categories covered 23 specific diagnoses. Within 3 months of admission 21% of the patients died, and the mortality varied from 4% in acute parenchymal jaundice to 49% in jaundice due to malignant disease.

Adult↗
PubMed1981

Accuracy of direct cholangiography by endoscopic or transhepatic route in jaundice--a prospective study.

An exact anatomic diagnosis of bile-duct obstruction is a prerequisite for selecting the appropriate management. In a prospective study on patients with clinically suspected obstructive jaundice, the results of direct cholangiography--by endoscopic retrograde or, alternatively, by transhepatic route--were compared with operative findings or liver biopsy or both. Final diagnoses were based on autopsy, operative biopsy, and clinical course. The study included 105 patients, 90 of whom underwent surgery, and allowed a blind and independent comparison between cholangiography and operative findings. The predictive value of a positive test, i.e., cholangiographic visualization of obstruction, was 0.99 and the predictive value of a corresponding negative test was 0.90, with the final diagnoses as reference. For the operated patients the predictive values were calculated as to obstruction (positive test 0.99, negative test 0.89), malignancy (positive test 0.92, negative test 0.89), and common duct stones (positive test 0.96, negative test 0.98). Thus, laparotomy can be avoided in patients in whom direct cholangiography shows no obstruction or an appropriate nonoperative procedure, like transhepatic insertion of a stent or endoscopic biliary surgery elected.

Biopsy↗
PubMed1980

Precision requirements in a study of computer-aided diagnosis of jaundice (the COMIK study).

Some 700 icteric patients have now been investigated by the Copenhagen study group for computer-aided differential diagnosis of jaundice (the COMIK study). The paper presents experience based on preliminary test runs using selected subsets of the data. In particular, the effect of the number of intervals into which quantitative laboratory variables are grouped has been stuied. Computer performance depends little on such grouping and, by inference, on analytical imprecision. As the grouping becomes finer, performance is even seen to deteriorate. These findings are in accord with theory and experience from other areas of pattern recognition, the problem being one of sample size. It is concluded that we are in a paradoxical situation of knowing from studies of single analytes that precision matters; yet when it comes to assembling information about a patients's condition we cannot make effective use of the precision of today's laboratories. This would seem to hold good whether data are processed by a computer, by physician, or by the two in collaboration.

Diagnosis, Computer-Assisted↗
PubMed1979

A gastroscopic and pharmacological study of the disintegration time and absorption of pivampicillin capsules and tablets.

1 An in vitro investigation showed that pivampicillin tablets disintegrated more rapidly than pivampicillin capsules. This result was demonstrated and confirmed by gastroscopy in a cross-over study in healthy volunteers. 2 There were no differences in serum levels of ampicillin obtained with the two preparations, but compared with non-gastroscoped volunteers, there was delay of 0.5--1.5 h in the appearance of peak serum ampicillin concentrations after gastroscopy. 3 Half of the volunteers receiving pivampicillin capsules developed hyperaemia, interstitial bleeding or erosions of the gastric mucous membrane. No such reactions were seen after pivampicillin tablets. 4 In one volunteer, a pivampicillin capsule was trapped in a not previously noticed hiatus hernia and local changes and pain occurred.

Adult↗
PubMed1979

Physiological significance of secretin in the pancreatic bicarbonate secretion. II. Pancreatic bicarbonate response to a physiological increase in plasma secretin concentration.

The pancreatic response to physiological concentrations of secretin obtained after minute boluses of exogenous secretin was studied in 16 normal volunteers. Output of bicarbonate into the duodenum was measured by duodenal aspiration in 5 subjects and by endoscopic cannulation of the pancreatic duct in 11 subjects. Pure natural porcine secretin was injected intravenously in doses of 125, 250, and 500 fmol x kg-1 body weight (0.0013, 0.0027, and 0.0054 clinical units x kg-1). All three doses of secretin increased plasma secretin concentration, duodenal bicarbonate concentration, and duodenal bicarbonate output significantly. The bicarbonate output measured by the two techniques did not differ significantly. The increments in median plasma secretin concentration were 1.6, 3.0, and 6.4 pmol x 1(-1) after secretin, 125, 250 and 500 fmol x kg-1, and the corresponding 15-min bicarbonate output 283, 442, and 1435 micromol, respectively. The concentrations of secretin in plasma found after these doses of secretin are of the same order of magnitude as the secretin concentrations found during physiological conditions in man. It is concluded that the physiological concentrations or secretin influence pancreatic bicarbonate secretion.

Bicarbonates↗