Biomedical subjects
Publications and source records attributed to R Sander.
A case of successful endoscopic papillotomy with the Nd YAG laser in a patient with choledocholithiasis after partial stomach resection is reported. This new technique is a complementary alternative for papillotomy when high-frequency diathermy is not suitable.
The concentrations of sodium, potassium, and chloride in various control sera were determined by reference methods. The reference method values were compared with the corresponding method-dependent assigned values. Sodium: Measurements by flame photometry and ion selective electrodes differed on the whole by less than 1% from the reference method value; determinations by photometry differed, however, by -4.7%. Potassium: The mean bias was -1.2% with flame photometry and -0.4% with ion selective electrodes, whereas nephelometric procedures differed by -1.9 or -4.8%. Chloride: Satisfactory agreement was obtained with values given for ion selective electrodes (-0.3%), for some coulometric procedures (-0.7 and 0.4%), and photometric determinations using mercury rhodanide (-0.5 and +0.7%). Values for mercurimetric titration and for photometric determinations using mercury 2,4,6-tri-(2-pyridyl)-s-triazine differed by + 2.5 and + 1.8%. Proposals concerning the allowable deviation from reference method values are discussed.
The Nd-YAG-laser is being used since ten years in gastroenterological endoscopy with good success. It can be used for treatment of bleeding lesions or lesions which potentially could bleed, for treatment of benign and malignant tumors, treatment of non-neoplastic stenoses and pathological changes in the region of the papilla. Own results with this treatment in 1033 patients are reported, demonstrating high efficacy of this method by improving quality of life and decreasing the number of surgical interventions necessary and also decreasing hospital lethality.
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This article describes 15 cocaine associated deaths in Utah in a 3 1/2-month period in early 1984, compared to 6 cocaine associated deaths for all of 1983. Brief case histories of the 15 cases are presented along with data on age, sex, county of death, cause of death, association of the cocaine with the death, cocaine analytical methodology, and a summary of cocaine concentrations in blood and urine. In four of the cases, cocaine by injection was the cause of death, whereas the other cases had cocaine or metabolite detected incidentally. The epidemiology of a single, well-defined cocaine source is described and related to this transient, remarkable increase in cocaine associated deaths.
In the gastrointestinal tract the Nd YAG laser has proved to be effective in hemostasis and tumor therapy. Initial experience in the treatment of benign stenoses reveals excellent results for this new indication, too. From July 1983 to March 1984 six patients with non-neoplastic stenoses of the esophagus (3) or the rectosigmoid colon (3) were treated with a Nd YAG laser. The lumen only was 3-7 mm, the length of the stenoses up to 7 cm. In all cases narrowing was successfully treated to an easy definitive passage of the 13 mm endoscope. Such symptoms as dysphagia, constipation or tenesms disappeared and no complications were seen. Reopening of non-neoplastic stenoses with Nd YAG laser is an alternative method to present-day conservative or surgical measures, being practicable, effective and of low risk to the patient.
Four non-tumoral stenoses - 2 peptic in the esophagus, and 2 postoperative in the rectosigmoid colon - have been successfully treated with Nd YAG laser without any complications. This new therapeutic technique represents a new approach to curative management and is basically capable of replacing surgical treatment.
Diagnostic relevance of ultrasonography was studied prospectively and controlled by peritoneoscopy and biopsy. 310 cases were investigated, 126 of these had fatty infiltration of the liver between 5% and 95%, which was diagnosed correctly in 92% of the cases by ultrasonography on the basis of increased reflexes. The incidence of correct diagnoses was 95% resp. 100% in cases with more than 10% resp. 50% fatty infiltration of the liver. Thus, diagnosis of fatty liver can be achieved with high sensitivity (fat infiltration of more than 10% may be recognized) and high specificity (only 4.35% false positives) by ultrasonography. Ultrasonography is a simple, non-invasive, and fast method suited for screening and follow-up in this condition.
Fotocoagulation was performed during 291 emergency endoscopies, mostly in the upper gastrointestinal tract with a neodym-yag-laser from Nov. 1st '78 to Okt. 30th '80; 324 sources of bleeding could be localized in the cases mentioned. Under optimal conditions an immediate stop of bleeding could be achieved in 99% by this procedure. In 27% of cases of upper gastrointestinal bleeding relapses occurred within 4 weeks after fotocoagulation, but only a few of these cases bled from areas coagulated before. Therefore it can be said, that neodym-yag-laser is a very effective instrument in stopping lifethreatening gastrointestinal bleeding, especially if the new transmission system is used (quartzmonofiber with coaxial CO2-jet-stream).
1. The lipogenic enzyme ATP citrate lyase (ATP:citrate oxaloacetate-lyase (pro-3S-CH2COO-acetyl-CoA; ATP-dephosphorylating), EC 4.1.3.8) is partially purified from human liver by ammonium sulfate fractionation and anionexchange chromatography. 2. Km values for the substrates are 1.1 x 10(-5) 1.3 x 10(-3), and 1.2 x 10(-4) M for CoASH, ATP and citrate, respectively. The hypolipidemic drug L(-)-hydroxycitrate is a competitive inhibitor with respect to citrate (Ki = 3 x 10(-4) M). 3. Specific activities measured in liver, adipose tissue and intestinal mucosa (autopsic and biopsic material) are in the range of 1 mU/mg protein suggesting that the citrate pathway does not significantly contribute to human lipogenesis. No stimulation is found after a 3-day carbohydrate-rich diet. 4. Specific activities of other key-enzymes of the acetyl-CoA production from carbohydrates (pyruvate dehydrogenase, cytosolic acetyl-CoA synthetase) are of the same low magnitude.
A new camera system is described, which was devised to take pictures of monitor screens on special X-ray film, and it is compared with conventional methods of documentation. Quality of pictures obtained with this method is optimal, handling is quick and simple, and, in spite of that, the camera is smaller and less expensive than other multiformate cameras. Polaroid, special X-ray films and other films may be used interchangeable for all sorts of monitor screens. A report is given about the routine use of this system in ultrasonography.
5774 colonoscopies were performed in 5 years, --including 2877 total colonoscopies and 1338 polypectomies. This confirms the diagnostic and therapeutic value of this method. Increasing experience of the endoscopist, better techniques as well as adequate pre-and postoperative care contribute to decreasing the risk of the polypectomy. If coagulation current is used exclusively the risk of bleeding can be lowered considerably.
Total colonoscopy was performed in 3,740 cases within approximately 4 years. Results show, that total colonoscopy may be used as a primary method of clinical examination in an optimal way, if the technically improved, new class of instruments is used. The new short ACMI F6S is especially suited for this approach, yielding reliable results in about 92% of all patients, if the colon is clean and if there are no organic stenoses present.
The forces developed on stretching bands of various sizes are tabulated to obtain approximate reference values for practice.
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