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Biomedical subjects

R Nilius

Publications and source records attributed to R Nilius.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Ambulatory diagnosis and therapy control of portasystemic encephalopathy in patients with liver cirrhosis].

The Number Connection Test (NCT) by Harold O. Conn was tested for its usefulness for diagnosis and treatment control of portasystemic encephalopathy in out-patients. For this purpose in 30 patients with liver cirrhosis the time in the NCT was determined and the serum ammonia level (NH3) was measured before the treatment with lactulose and neomycin was started. Moreover, 12 clinical symptoms and 10 laboratory parameters were tested for correlation with the NCT-time. We found a positive correlation between the NCT-time and NH3 serum level. For the prediction of the NCT-time the multiple linear regression yielded the combination of NH3 with the proof of ascites and palmar erythema as the best subset of predictor variables. By means of the NCT the effectiveness of the treatment with lactulose and neomycin was demonstrated. We recommend the NCT for the clinical routine in particular for the early diagnosis and for treatment control of portasystemic encephalopathy in patients with liver cirrhosis.

Aged↗
PubMed1984

[Experiences with endoscopic sclerosing of esophageal varices].

In this paper is reported on endoscopic sclerotherapy in 35 patients, which have been treated from March 1980 to March 1983. The efficacy of submucosal (paravascular) wall sclerosis wasn't sufficient. We achieved better results in the prevention of esophageal variceal bleeding with combined para- and intravascular injections of sclerosant.

Esophageal and Gastric Varices↗
PubMed1984

[Heart arrest in gastroscopy--report of 2 cases].

Two cases with cardiac arrest in the early phase of gastroscopy are presented. In a 83-years-old patient, the external cardiac reanimation was successful, but nevertheless the cardiac intensive therapy a 85-years-old woman died. The possible causes of cardiac complications of gastroscopy are discussed and consequences for premedication are proposed. This first communication about a fatal complication during gastroscopy in the GDR is reported to emphasize the potential rare but serious dangers of gastroscopy.

Aged↗
PubMed1983

[Results of sonographic kidney diagnosis].

In a prospective study of the examination of the accuracy of the ultrasound tomography in the renal diagnostics the kidneys of 361 patients could be demonstrated as at 100% sufficiently to be judged. Tumours, congestion kidneys, cystic kidneys/renal cysts and cirrhoses of the kidney were diagnosed with an efficiency of 0.92-0.96-0.97-1.0. The sensitivity was in the same order 0.90-0.96-0.99-1.0 and the specificity 0.94-1.0-0.95-1.0. Insufficient results were obtained by the sonographic search for renal calculi. As non-invasive and rapid method of diagnostics the sonography in a valuable way contributes to the differentiation of the symptom "quiescent kidney" and oligo-anuria.

Humans↗
PubMed1983

Levamisole therapy in chronic hepatitis--results of a multicentric double blind trial.

The effectiveness of levamisole in the immunmodulatory treatment of chronic hepatitis was assessed in a multicentric double blind trial. Twenty patients received in the first week 50 mg, in the second 100 mg and thereafter 150 mg, levamisole on two days every week for 6 months, 20 others received a placebo. Five patients dropped out (non-compliance 1, pregnancy 1, adverse effects 3). The diagnoses were confirmed by clinical, biochemical immunological and histological data. After 6 months 26 subjects allowed us to take a control liver biopsy. The results showed that the rate of improved, unchanged and impaired cases was not significantly different in the levamisole and placebo groups. No correlation was found between etiology, activity or histological type of chronic hepatitis, skin test reactivity (DNCB, PPD, Streptokinase) and therapeutic effect, respectively. Clinical improvement was not associated with the elimination of HBs antigen. In general levamisole was well tolerated, but we saw one case of severe agranulocytosis.

Chronic Disease↗
PubMed1983

[Immunologic aspects in the pathogenesis of Dupuytren's contracture].

In 30 patients suffering from Dupuytren' disease the following cellular and humoral tests were carried out: 1. Migration inhibitory test using the palmaraponeurosis as an antigen. - 2. Determination of the serum level of IgG, IgA and IgM. - 3. Determination of humoral antibodies against mitochondria, cellnuclei and smooth muscles. - An inhibition of migration could be observed in 24 out of 30 patients (80%) (MI 0.85). 6 patients had a migration index above 0.85. The serum-level of IgA was elevated in 12 patients. IgG was abnormal in only 5 patients out of 30; the same was true for IgM in 3 out of 30 patients. In 4 patients low titers of humoral antibodies could be found. Consequently, the conclusion is drawn that inadequate cellular immunoreaction against the same body tissue could be a prerequisite for the development of Dupuytren's disease.

Autoantibodies↗
PubMed1983

Aldehyde dehydrogenase (E.C. 1.2.1.3) in chronic alcoholic liver diseases.

Acetaldehyde dehydrogenase (ALDH) activity in liver biopsy specimens was considerably reduced in alcoholic cirrhosis (n = 5), elevated in alcoholic fatty liver (n = 11)--probably due to enzyme induction--only slightly elevated in alcoholic hepatitis (n = 6), but unaffected in non-alcoholic liver diseases (n = 23) in comparison with specimens obtained from patients with minimal liver lesions. We will argue as a working hypothesis that alcoholics with induced ALDH activity will mainly develop fatty liver, whereas reduced hepatic ALDH appears to be a reason for elevated acetaldehyde levels followed by additional liver injury and progression at least for alcoholic cirrhosis.

Aldehyde Dehydrogenase↗
PubMed1983

[Results of ultrasonic tomography in the diagnosis of gastrointestinal diseases].

A thickening of the stomach or intestinal wall as a result of neoplastic or inflammatory infiltrations can be principally recognized by sonography as a "Cocarde phenomen". The question of the accuracy of ultrasonic tomography in the recognition of infiltrative diseases of the gastrointestinal tract has been examined in a prospective study. 80 patients who were suspected of having such a disease were sonographed, using the real-time method. The diagnose were verified by an adequate comparative method, by surgery or autopsy. An infiltrative gastrointestinal disease was correctly diagnosed by sonography in 42 cases, including nine cases of gastric carcinoma and of 27 colon carcinoma. Two patients were suffering of Crohn's disease, and in the remaining four cases the final diagnoses were bulbitis, Ménétrier's disease, diverticulitis and penetrating ulcus ventriculi, respectively. In 27 cases an infiltrative gastro-intestinal disease was correctly exclused by sonography. Ultrasonic examination wrongly produced a negative diagnosis in five cases and a positive in six. Thus, the efficiency of the examination was 0,86, the sensitivity 0,89 and the specifity 0,82. Ultrasonic tomography should therefore be assigned a major place in gastrointestinal diagnostics, too. It could point the way in many cases. It is not possible, however, to exclude a disease by means of sonography.

Autopsy↗
PubMed1982

[Acetaldehyde-induced leukocyte migration inhibition in alcoholic liver diseases].

Acetaldehyde in non-toxic doses (15.6 micrograms per start) causes in the inhibition test of the migration of leucocytes an inhibition of the migration in 6/13 of the patients with alcoholic hepatitis, a stimulation of the migration in 6/11 of alcohol cirrhoses. Healthy (n = 16) persons, patients with alcoholic fatty degeneration of the liver (n = 3) as well as non-alcoholic liver diseases (chronic persisting hepatitis, n = 11; chronic active hepatitis, n = 8, cirrhosis, n = 7) did not show this cellular immune reagibility. The inhibition of the migration and the stimulation of the migration, respectively, might develop by hapten autoantigen complexes (altered cytoskeleton?) with release of the factors of inhibition of migration and stimulation of migration, in which case the role of a hapten belongs to acetaldehyde. The results of the tests did not correlate with functional and histological findings of the liver, with the actual consumption of alcohol and also not with haptoglobin phaenotypes. When it is postulated that by acetaldehyde also the release of further lymphokines is mediated, origin and progression of alcoholic hepatitis and alcoholic cirrhosis might be explained immunopathogenetically.

Acetaldehyde↗
PubMed1982

[Cell-mediated immune reactivity in skin tests in chronic liver diseases].

For the judgment of cell-mediated immune reactivity in patients with chronic liver diseases in comparison to healthy test persons tests of the skin were performed by means of the neoantigen DNCB and the recall antigens tuberculin and streptokinase. Depending on the degree of severity of the hepatopathies the intensity of reaction decreased in the DNCB-test. There were no relations to the etiopathogenetic factors of the liver diseases. The results speak for the fact that the disturbed immune reactivity to DNCB is to be regarded as sequela of the disease. The anamnestic immune response controlled by means of the two recall antigens did not show any quantifiable differences to the reference collective in the chronic hepatopathies. It is concluded that the findings of skin tests are not able to contribute to the indication for immunosuppressive or immune modulating therapeutic methods.

Chronic Disease↗
PubMed1982

[Pathophysiology and laboratory diagnosis of cholestasis].

Cholestasis--defined as a reduction or stasis of bile flow with corresponding rise of bile substances in blood--can be caused by obstructive and non-obstructive mechanisms. Common pathomechanisms, manifesting mainly in centrolobular liver areas, can be classified with regards to the subcellular location of the cholestatic components: Impairment of sinusoidal and lateral hepatocyte membrane; disturbance of bonds, storage, transport and secretion of bile substances (particularly reduction of bile-acid dependent and non-dependent bile flow); impaired bile acid and drug metabolism as a result of hypoactive, hypertrophied endoplasmatic reticulum; impairment of the mitochondrial energy metabolism; alteration of the canalicular membrane; impairment of filaments and "tight junctions"; the building of precipitates resulting from disturbed micellar function; impairment of ductulus permeability with reabsorption of bile.--These pathomechanisms explain the behaviour of biochemical and cholestatic-specific symptoms in blood-plasma, inclusive the appearance of abnorm substances whose diagnostic values are illustrated.

Carrier Proteins↗
PubMed1982

[Ultrasound determination of size and calcium content of gallstones].

In a prospective study, ultrasound examinations of the gallbladder as well as cholecystocholangiography were carried out in 77 patients with solitary stones and the ultrasound stone symptoms were compared with the x-ray findings. The ultrasound stone reflex as well as the wideness of the sonic-shadow correlated significantly with the size of the stones. The stone size can be approximately calculated from the wideness of the sonic shadow. On the other hand dependence of the ultrasound stone symptoms and the radiographic defined calcium was not evident. While the stone size can be sonographically defined, the indentification of calcium in gallstones continues to remain a domain of radiographic methods.

Calcium↗
PubMed1981

[Alkaline phosphatase isoenzymes and hyperthyroidism].

We determined the serum total alkaline phosphatase as well as the alkaline phosphatase isoenzyme pattern in untreated and treated hyperthyreoses in the condition of euthyreosis and compared them with those of a healthy control group. The isoenzyme patterns, expressed as L/K quotient, ranged between 1.3 and 2.5 in the normal group and between 0.3 and 1.3 in the group with hyperthyreosis. The increase of the total alkaline phosphatase in hyperthyreosis was nearly exclusively conditioned by the increase of the activity of the osseous isoenzyme. The latter was increased already also then, when the total alkaline phosphatase had not transgressed the upper border of the normal. Depending on the functional condition of the thyroid gland the liver isoenzyme did not show any significant changes. In the course up to one year under thyrostatic therapy the increased activity of the osseous alkaline phosphatase decreased into the normal region as an expression of the very slowly repairing hyperthyreosis-conditioned disturbances of the osseous metabolism. An increase of the activity of the total alkaline phosphatase or of the osseous isoenzyme in the initial phase of a thyreostatic therapy of the sequel of an increase of the reactive activity of osteoblasts and must not lead to diagnostic and therapeutic uncertainties. By reason of the high sensitivity of the L/K quotient in hyperthyreoses (L/K at 95.5 % below 1.3) with a simultaneously high specifity of 89.5% the alkaline osseous phosphatase is to be discussed by all means as a helpful parameter of the peripheral function of the thyroid gland.

Alkaline Phosphatase↗