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Biomedical subjects

R Ottenjann

Publications and source records attributed to R Ottenjann.

At least 55 records · Page 3Linked to original sources
PubMed1988

[Ofloxacin in therapy of "resistant" duodenal ulcer. A pilot study].

Since its description in 1983 Campylobacter pylori (C.p.) has been discussed as possible pathogenic factor at least in duodenal ulcer disease. The therapeutic combination of H2-receptor-antagonists (= H2-RA) and ofloxacin (Tarivid) has shown to heal resistant duodenal ulcers in some preliminary cases, which did not respond to a three month standard dosage treatment with H2-RA. This paper describes the results of twelve patients whose duodenal ulcers were resistant to H2-RA. C.p. was detected in all patients before therapy. The combined treatment with ofloxacin and H2-RA healed the duodenal ulcers within 2 weeks in 6 patients, within 4 weeks in 2, and within 6 weeks in 4 patients as proven by fortnightly performed endoscopic controls. At the end of therapy C.p. was not detected in 11 of 12 patients. The MIC's of ofloxacin for C.p. ranged from 0.5-1 microgram/ml in six investigated patients. The results suggest a possible pathogenic role of C.p. in duodenal ulcer disease.

Adult↗
PubMed1988

The role of antibiotics in Campylobacter pylori associated peptic ulcer disease.

Since the recognition and first culture of Campylobacter pylori (Cp) the hypothesis of a pathogenic role has been strengthened by numerous investigations. Its close association with active chronic gastritis and even active duodenitis, and the disappearance of these pathologic conditions with antimicrobial treatment suggest a pathogenic role for Cp in active chronic gastritis. The close association of antral gastritis with duodenal ulcer (DU) suggests that Cp associated active chronic gastritis may be an important precondition for the development of DU. Therapy studies so far using either bismuth, antibiotics, or a combination of both could demonstrate that the healing of DU ulcer was closely related to the clearance of Cp and healing of gastritis. Relapse of DU was closely associated with reappearance of Cp and active chronic gastritis. At the present state the combination of bismuth salts and antibiotics has achieved the highest eradication rates of Cp and thus lowest relapse rates of DU. Antibiotics therefore seem to be an indispensable factor in the antimicrobial treatment of Cp associated diseases.

Anti-Bacterial Agents↗
PubMed1987

[Ofloxacin in the therapy of Campylobacter pylori-positive duodenal ulcer. A prospective controlled randomized study].

50 patients with duodenal ulcer and Campylobacter pylori cultured from the antral mucosa were randomly divided into two groups of 25. They received either ranitidine 300 mg at night or the same dose of ranitidine combined with twice daily 200 mg ofloxacin. Endoscopic check and biopsy for histological and microbiological tests were performed every two weeks until demonstrable cure of the ulcer. After two weeks the cure rates were 44 and 80%, respectively, after four weeks 68 and 92%, and after six weeks 88 and 100%. The difference in healing time between ranitidine alone and ranitidine plus ofloxacin was statistically significant (P less than 0.025). Campylobacter pylori was no longer demonstrable in two of 25 patients after ranitidine alone and in 24 of 25 after ranitidine-ofloxacin. The minimal inhibitory concentration of ofloxacin against tested Campylobacter pylori strains was 0.5-1.0 micrograms/ml. Both groups were comparable as to age and sex distribution; duration of history of ulcer, and number of previous ulcers; nicotine and alcohol consumption; intake of nonsteroidal antirheumatic drugs; other previous treatment; size and complications of the ulcers; and number of accompanying diseases. The results speak for Campylobacter pylori playing a role in the pathogenesis of duodenal ulcer.

Adult↗
PubMed1987

[Internal biliary drainage in the "rendezvous" procedure. Combined transhepatic endoscopic retrograde methods].

Positioning of an internal biliary drainage is the treatment of choice in inoperable malignant stenoses of the ductus hepatocholedochus. The "rendezvous procedure" combines percutaneous transhepatic and endoscopic retrograde cholangiography. It enables positioning of the internal drain in about 95% of the cases within 40-60 minutes at a low complication rate. This method has been applied so far in 22 patients and was successful in 21 cases. A steel guide protected by a plastic catheter is advanced transhepatically into the duodenum. Papillotomy which cannot be achieved by conventional technique is performed by the Mori-knife technique. The drain (French 11-12) is positioned with endoscopic viewing employing the conventional technique. Highly positioned or long stenoses can be overcome more effectively with this method. The transhepatic guide can be tautened, resulting in a markedly enhanced thrust to position a drain in patients with Billroth II gastrectomy. Conversion of percutaneous to internal biliary drainage is usually feasible.

Aged↗
PubMed1987

[Gastrointestinal bleeding in solitary colonic ulcers].

With the spread of coloileoscopy, solitary colon ulcers are being diagnosed more frequently nowadays. Their clinical significance consists in the differential diagnosis of gastrointestinal bleeding and abdominal pain. Whereas they were formerly diagnosed surgically only in complications such as perforation or massive hemorrhage, they are mainly discovered coloscopically today and are characterized by a course which can be controlled conservatively. The characteristics appear to be essentially unchanged: sex ratio (about 1:1), age peak (in the fifth decade of life), age distribution (20-80 years), in occasional cases up to four ulcers, diameter (a few millimeters up to about three cm) and localization (Bauhin's valve 58%, ascending colon 13%, cecum and sigmoid colon 10%). The histological investigation of biopsies reveals mainly unspecific alterations. The pathogenesis is mostly unknown, but above all ischemia, drugs and inflammatory processes are suspected to be the cause.

Biopsy↗
PubMed1986

Granular cell tumor in upper GI-tract endoscopy. Five cases of esophageal location.

Five cases of esophageal granular cell tumor are reported with characteristics similar to those of benign tumors described previously. In contrast to previous reports these tumors are suitable for removal by endoscopic means, provided they are small and are strictly submucosal in location. This view is further supported by the still open discussion as to histogenesis, and the contradictory opinions on its biological significance. Owing to the increasingly widespread use of fiberoptic instruments the diagnosis "granular cell tumor" will become more common. The diagnosis must always be confirmed histologically. Since the tumor may invade adjacent tissue, or even show a tendency to malignant degeneration in late stages, endoscopic removal seems necessary.

Adult↗
PubMed1986

Bioptic microbiology in the differential diagnosis of enterocolitis.

Parameters in the differential diagnosis of enterocolitis have been poorly evident for many years. Development and profitable employment of endoscopic instruments were the first step towards advancing the diagnostic facilities in inflammatory bowel disease. The microbiologic examination of mucosal biopsies creates a new diagnostic dimension, and it distinctly seems to increase the diagnostic sensitivity for pathogens. Within fifteen months 152 patients admitted to the gastroenterologic unit with acute, or symptoms of exacerbated, bowel disease were examined for the aetiologic agents. Compared with former reports, idiopathic inflammatory bowel disease (IIBD) such as Crohn's disease (32.2%) and ulcerative colitis (18.4%) were decreased. Infectious colitis (22.3%), mostly Campylobacter or Yersinia infections, was, sometimes exclusively, diagnosed by bioptic microbiology, non-classifiable forms of colitis (21.7%), and rare forms (5.4%) were diagnosed more often. It proved to be important that IIBD was frequently superinfected by Campylobacter, Yersinia and Chlamydia, and the differential diagnosis was complicated, since these microorganisms can mimic IIBD. The results suggest that coloileoscopy combined with bioptic microbiologic investigation additional to faecal samples should include a search for Campylobacter and Yersinia. It appears indispensable that the final diagnosis "Crohn's disease" or "ulcerative colitis" should be confirmed by sequential coloileoscopy and microbiologic examination.

Adolescent↗