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Biomedical subjects

R Rogos

Publications and source records attributed to R Rogos.

At least 37 records · Page 2Linked to original sources

[Changes in carbohydrate metabolism in liver cirrhosis during glucose infusion tests].

In 31 patients with normal liver findings, fatty degeneration of the liver and liver cirrhosis the behaviour of parameters of the carbohydrate metabolism (blood glucose, IRI, lactate, glycogen of liver and muscle) was tested under a two-hour glucose infusion. Accumulation of pathological carbohydrate tolerance and hyperinsulinaemia and the reduced content of liver glycogen in liver cirrhoses are traced back to a decreased functional reserve of the diseased liver. On the other hand, the reduction of lactate was normal as a criterion of the gluconeogenesis. Lactacidoses did not appear despite advanced liver cirrhoses. The increase of the reduced reserves of glycogen in liver and muscle after the offer of glucose refers to preserved regulation mechanisms in supply of substrates despite peripheral insulin resistance.

Adult↗

[Percutaneous antegrade pyelography with a fine needle].

In 15 patients the percutaneous antegrade pyelography with thin needle was performed for the clarification of a mute kidney and a urinary stasis kidney. The two groups of diseases could not be clarified by means of the methods of the conventional urography. The retrograde pyelography was intentionally given up. By means of the percutaneous antegrade pyelography we could clarify a mute kidney in 8 cases and in 4 cases a urinary stasis kidney. In 3 cases with mute kidney we did not succeed in the demonstration of the renal calyces. No complications appeared. In strong indication the percutaneous antegrade pyelography is an evident diagnostic measure by great security, little stress for the patient and little cost. Despite modern investigation methods including sonography and computer tomography is referred to the fields of application of the percutaneous antegrade pyelography.

Biopsy, Needle↗

[Diagnostics of biliary ducts in anicteric patients by percutaneous transhepatic cholangiography (PTC)].

Under the conditions of a clinical symptomatology and of the insufficient diagnostic evidence of non-invasive cholangiographic methods the percutaneous transhepatic cholangiography was tried in 70 anicteric, above all cholecystectomized patients. The representation was successful in 84.3%. From this relatively high rate of success, the frequent proof of pathological changes and the indication to an operation which is to be derived from this the justification for the performance of the percutaneous transhepatic cholangiography, independent of the symptom icterus, but above all in dilated biliary ducts, is established. The crossing of the indication regions of percutaneous transhepatic cholangiography and ERC demands, apart from the demarcation of the application of the two methods, that both techniques supplement each other and have own regions of application.

Adult↗

[Percutaneous transhepatic radiomanometry of the bile ducts (PTC-manometry) (author's transl)].

Method and first results of the PTC-manometry are shown in 32 cases. Low residual pressures in bilio-digestive anastomosis and high results both in incomplete bile obstruction and in anicteric patients with incomplete stenosis of the common bile duct and with papillary stenosis suggest a clinical importance. In connection with clinical symptoms and x-ray results it is possible to give informations already preoperatively which we could got only by intraoperative radiomanometry till now. There was no correlation between the maximum size of the common bile duct and the residual pressure.

Adult↗

[Emergency endoscopy in acute upper gastrointestinal hemorrhage: Does the effectiveness justify the effort?].

On the basis of a common care of patients with acute upper gastrointestinal haemorrhage by internists, surgeons, and anaesthetists lasting several years advantages and disadvantages of emergency endoscopy are analysed from the standpoint of effectivity. High diagnostic ability, help in the decision concerning operative or conservative activity, the influence of the operative-tactic approach and the furthering influence on the close cooperation of the specialities are to be emphasized. Criteria of effectivity, such as mortality rates, duration of the stay in the hospital and frequency of relapsing haemorrhages underlie many factors of influence. They express results of therapy, to which emergency endoscopy may at present contribute only limitedly. The basic decision to medical activity -- active striving for a rapid, exact diagnosis or waiting when the diagnosis is uncertain -- does not inessentially influence the standpoint in the controversy about the emergency endoscopy.

Acute Disease↗

[Fine needle percutaneous transhepatic cholangiography (PTC)].

The percutaneous transhepatic cholangiography with thin needle was performed in 40 patients for the diagnostic clarification of epigastric complaints after cholecystectomy and of a cholestasis syndrome. A successful demonstration of the duct was achieved altogether in 80%, in an extrahepatic obstruction in 93.3%. The only complication was a choleresis into the free abdominal cavity, which could be operatively treated without any sequels. By the percutaneous transhepatic cholangiography in the majority of patients pathologic changes were diagnosed, which remained latent when up to now usual methods were performed and which had therapeutic consequences. The high exactness, the slight load of the patient, minimum cost and unproblematic sterilisation are essential advantages of the percutaneous transhepatic cholangiography which justify a broader use. The complication rate may be kept low by the slight calibre of the needle and by suitable investigation technique.

Bile Duct Neoplasms↗

[The protease inhibitor potential in newborns with respiratory distress syndrome].

In 70 newborns with respiratory distress syndrome (RDS) and in roughly the same number of eutrophic mature newborns the total antiplasmin, progressive antithrombin and alpha 2-macroglobulin was determined, the latter in an enzymatical as well as immunochemical way. In healthy mature newborns the progressive antithrombin was somewhat below the level of adults, alpha 2-macroglobulin was above it in both methods and total antiplasmin within it. All parameters of protease inhibitory capacity were significantly lowered in newborns with RDS. Smaller values could be found in patients with bleedings and in those who died later on. Even in those patients with a birth weight under 2,000 g there was a tendency to lower values which can only be partially due to the specificity of development of inhibitors. Progressive antithrombin, total antiplasmin and alpha 2-macroglobulin determined enzymatically are correlated in newborns with RDS jointly and with numerous other parameters of the coagulation system. These relations point to the fact that all components are included in the same consumption process, viz. in the process of disseminated intravascular coagulation. Alpha 2-macroglobulin values determined immunochemically do not correlate with coagulation parameters determined enzymatically as well as with other parameters. They lay partially above or below those determined enzymatically. This behaviour can only be explained by a partial enzyme complex binding of alpha 2-macroglobulin in newborns with RDS.

Antithrombins↗

[The behavior of albumin in acute and chronic liver damage. III. Intrahepatic and serum albumin concentrations in human liver diseases].

In 305 patients examined by liver biopsy albumin and the entire soluble protein in the liver puncture as well as albumin in the serum were estimated quantitatively. A significant decrease of the serum albumin level in active cirrhoses and biliary liver damages confirmed the importance of the hypalbuminaemia as facultative symptom of a liver damage. The lacking specifity was emphasized by the low albumin serum concentrations in malignomas and after the intake of contraceptive hormones. The hypalbuminaemia and the increased content of soluble liver protein in the bioptic material might enrich the diagnostics of the activity in cirrhoses. The diagnostic value of the decrease of the relative proportion of albumin is low, since of all liver diseases examined the active cirrhosis alone was accompanied by a significant decrease. The estimation of the albumin content in the bioptically got liver tissue had in contrast to the animal experiment no diagnostic value for liver diseases.

Albumins↗

[The behavior of albumin in acute and chronic liver diseases. I. The behavior of albumin during the development of rat thioacetamide cirrhosis].

The behaviour of albumin during the development of chronic progressing liver damages was investigated on the model of the thioacetamide cirrhosis in Wistar-rats. Simultaneous estimations of the albumin concentrations in extractable liver protein and in the serum as well as accompanying measurements of the total protein and of the transaminases SGOT and SGPT in the serum allow a complex judgment. The albumin concentration in the liver significantly decreased after 4 and 8 weeks and reached highly normal values in fully developed cirrhosis. In each case the serum level changed in the same sense, but less expressed. The total protein in liver and serum showed an analogous course of the curve, whereas the albumin-total protein-quotient in the liver remained unchangedly low. The relative proportion of albumin in the serum did not show a diminution in every phase. The simultaneous decrease of albumin and total protein are explained as an expression of an inhibition of the synthesis due to destruction of protein-synthesizing subcellular structures. The normalisation of the serum levels and of the highly normal albumin contents despite the developed cirrhosis become understandable by the loss of efficiency of the foreign substance thioacetamide in consequence of structural and biochemical adaptation. The thioacetamide cirrhosis of the rat in the investigated phase despite the microscopically provable so-called degenerative parenchymal damages is accompained by parameters of the increased protein metabolism. The relative serum albumin content apparantly in the first place undergoes the oncotic pressure regulation and is not suited as the measure of a hepatocellular lesion. From the diagnostic point of view the reduction of the albumin concentrations seems to be of importance in the developmental phase to cirrhosis.

Alanine Transaminase↗

[Diagnostic value of bulboscopy].

Bulboscopy is a proved routine examination in radiological suspicion of changes in the duodenum, in duodenal ulcers, haemorrhages from the superior gastrointestinal tract, also as emergency endoscopy, and in unclear epigastric complaints. The endoscopy of the duodenal bulb is better than the radiological examination, especially when a cicatricial bulb is present. Flat ulcers often cannot be proved by radiological examination. Nevertheless the radiological examination should always be carried out, as also endoscopically in the cicatricial bulb ulcers may be overseen. Endoscopically the florid duodenal ulcer can be differentiated in several groups. Some a prognostic importance is ascribed.

Duodenum↗

[Permeation-increasing activity of puncture-fluids: 2. Chromatographic and immunoelectrophoretic studies].

A human pleural effusion was separated by gel chromatography, DEAE-chromatography, disk-electrophoresis and immunoelectrophoresis. The fractions obtained were tested for the permeation-increasing activity. IgA, IgM, IgG, transferrin and haptoglobin are not responsible for a permeation-increasing effect. Albumin, alpha1-antitrypsin, acid alpha1-glycoprotein and alpha2-macroglobulin appear only in permeation-active fractions. Of these proteins, however, no direct effect on the permeability of animal membranes is known. It is discussed, whether proteolytic enzymes, which may be bound to these proteins are responsible for the increase of permeation.

Adult↗

[Chronic liver diseases with negative laboratory findings].

Chronic liver diseases may be overlooked, when regular laboratory-chemical findings are overvalued. This is important especially for those which coincide with a particupation of the bile ducts. Even in insignificant clinical references laparoscopy and biopsy under direct vision are necessary. The blind biopsy of the liver is not always sufficient as it does not regularly deliver characteristic tissue.

Biopsy↗