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Biomedical subjects

T Sauerbruch

Publications and source records attributed to T Sauerbruch.

At least 361 records · Page 20Linked to original sources
PubMed1988

Risk indicators of variceal bleeding.

Variceal bleeding is a catastrophic event in the history of liver cirrhotics. However, in more than half of the patients it never occurs. Thus, measures to prevent bleeding should be undertaken only in patients at the highest risk of bleeding. Risk indicators should help to select those patients. Hemodynamic and endoscopic parameters as well as liver function and coagulation status and the patient's history have been studied in relation to the bleeding incidence. The following parameters are correlated with an increased bleeding risk: The first year after diagnosis of varices, a positive history of variceal bleeding, presence of varices with large diameters, high blood pressures or a red colour sign, concomitant gastric varices or development of a liver cell carcinoma. Other parameters may be of less importance for the occurrence of variceal bleeding.

Endoscopy↗
PubMed1987

Injection sclerotherapy of oesophageal variceal haemorrhage. A prospective long-term follow-up study.

One-hundred-seventy-five patients with oesophageal variceal bleeding and liver cirrhosis who underwent long-term injection sclerotherapy were prospectively followed for 44 +/- SD 17 months. While aetiology (alcoholic vs. non-alcoholic cirrhosis) had no influence on survival, the Child status assessed at the time of initiation of sclerotherapy was of important prognostic value (mortality rate after a mean follow-up of 44 months: Child A 5%, Child B 45%, and Child C 83%). Initiation of sclerotherapy (elective vs. emergency) had no influence on survival in the A/B patients, whereas electively treated Child C patients had a somewhat better outcome than those in whom sclerotherapy was started during active bleeding. Rebleeding, especially within the first two months after starting repeat sclerotherapy, was significantly influenced by the Child status of the patients. About one-fourth of all deaths were combined with rebleeding in the Child B and C patients, but none of the A patients had intestinal bleeding prior to death. It is concluded that Child A patients have an excellent long-term prognosis after variceal haemorrhage treated by repeated endoscopic injection of the varices.

Adolescent↗
PubMed1987

Disintegration of a pancreatic duct stone with extracorporeal shock waves in a patient with chronic pancreatitis.

We report the case of a 33-year-old woman with chronic calcifying pancreatitis in whom an intraductal pancreatic stone with a diameter of 8 mm was successfully disintegrated with extracorporeal shock waves, permitting subsequent endoscopic extraction of the fragments. The patient had a mild attack of pancreatitis after the treatment. We conclude that shockwave lithotripsy of a pancreatic duct stone in patients with chronic pancreatitis is possible. It should, however, be viewed with reservation until further experience has been gained.

Adult↗
PubMed1987

Intestinal involvement in progressive systemic sclerosis detected by increased unconjugated serum bile acids.

In patients with progressive systemic sclerosis, impaired motor function of the small intestine may lead to bacterial overgrowth causing diarrhoea, steatorrhoea and malabsorption. As unconjugated serum bile acids have been proposed as markers for small bowel bacterial overgrowth, we studied individual unconjugated serum bile acids in 36 patients with progressive systemic sclerosis. These patients had significantly higher serum concentrations of unconjugated cholic acid (median 0.18; range 0.05-30.75 v 0.09; 0.01-0.19 mumol/l, p less than 0.001) and chenodeoxycholic acid (0.10; 0.01-6.83 v 0.04; 0.01-0.39 mumol/l, p less than 0.025) than healthy controls (n = 16). This difference was mainly due to patients with diarrhoea (n = 10), who had significantly higher concentrations of unconjugated serum bile acids than patients with normal bowel habit (cholic acid median 0.55 v 0.16 mumol/l, p less than 0.001; chenodeoxycholic acid 0.75 v 0.07 mumol/l; p less than 0.005). All patients with raised unconjugated serum bile acids had oesophageal motility disorders. These results confirm a relationship between motility disorders and bacterial overgrowth in patients with progressive systemic sclerosis.

Bile Acids and Salts↗
PubMed1987

[Atrial natriuretic factor. Initial results of possible significance in liver cirrhosis].

The discovery of the first well-defined natriuretic hormone, the Atrial Natriuretic Factor (ANF), has prompted research on its impact on volume regulation in health and disease. The natriuretic, diuretic, and smooth muscle-relaxing properties suggest an important role of this novel hormone in pathophysiological states with sodium or volume retention, such as congestive heart failure or cirrhosis of the liver. Investigations on the implications of ANF in liver disease have been performed for a short period only, and results are still controversial in many respects. At present, it seems very likely that there is no absolute deficiency of plasma ANF in patients with cirrhosis. Moreover, elevated plasma levels in cirrhotics with ascites have been reported by several groups. However, as yet, a molecular characterization of this increased immunoreactivity is still lacking. There is disagreement on the reduced release of and renal response to ANF in subgroups of cirrhotics; however, stimulus-response-coupling might be impaired. Further studies are needed to elucidate the pathophysiological implications and therapeutical potential of ANF in patients with chronic liver disease.

Atrial Natriuretic Factor↗