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T Sauerbruch

Publications and source records attributed to T Sauerbruch.

At least 397 records · Page 22Linked to original sources
PubMed1984

Simultaneous determination of cholic acid and chenodeoxycholic acid pool sizes and fractional turnover rates in human serum using 13C-labeled bile acids.

A method has been developed for simultaneous determination of pool sizes and fractional turnover rates (FTR) of chenodeoxycholic acid (CDCA) and cholic acid (CA) in man by 13C/12C isotope ratio measurements of bile acids in serum after oral administration of 20-50 mg of [24-13C]-labeled bile acids. 13C/12C isotope ratio measurements were performed by capillary gas-liquid chromatography/electron impact mass spectrometry. CA and CDCA kinetics in serum measured by this method exhibited first order kinetics and permitted calculation of pool size and FTR of CA and CDCA. The validity of the measurements in serum was tested by simultaneous measurements in bile in three healthy volunteers and in five patients with various hepatobiliary disorders (three patients with cirrhosis, one with cholecystectomy and sphincterotomy, and one with sphincterotomy only). No consistent differences were found between the pool sizes and FTR's obtained from serum and bile. In a total of five healthy volunteers bile acid kinetics were measured in serum. The values found for the pool sizes and FTR's of CA and CDCA in these subjects were in excellent agreement with data reported in the literature based on 14C or 3H measurements in bile. The pool sizes (mean +/- SD) of CDCA and CA were 32.6 +/- 9.9 and 31.8 +/- 16.0 mumol X kg-1, respectively. The corresponding values for the FTR's were 0.24 +/- 0.13 and 0.48 +/- 0.22 d-1. These data demonstrate that pool sizes and fractional turnover rates of cholic and chenodeoxycholic acid can be measured simultaneously by blood sampling after oral administration of the respective 13C-labeled bile acids.

Adult↗
PubMed1984

[Long-term sclerosing therapy of bleeding esophageal varices. A prospective course study].

Longterm sclerotherapy by flexible endoscopy was done in 109 patients with acute bleeding from oesophageal varices in a prospective follow-up study. The severity of the liver disease was classified according to Child (Pugh's modification) at the beginning of treatment. Patients were followed-up for at least 12 months with a maximum of 44 months. The one-year survival rate for all patients was 67%. Child-A patients (100%) and child-B patients (84%) had a significantly better survival than Child-C patients (36%; P less than 0.001). The rate of haemorrhage per patient-month was significantly lower (P less than 0.001) in Child-A patients (0.4%) and Child-B patients (2.4%) than in Child-C patients (8.5%). After initial sclerosing of 8 weeks' duration the rate of recurrent haemorrhage was only 1.3% per patient-month. There was a significant difference (P less than 0.005) between Child-A patients (0.2%) and Child-B and -C patients (2%). The data show that Child-Pugh's classification permits a high prognostic accuracy in predicting results of sclerotherapy. Child-A and -B patients are suitable candidates for longterm sclerotherapy whereas Child-C patients show a clearly increased risk of recurrent bleeding during the early phase of treatment and have a markedly reduced survival rate.

Esophageal and Gastric Varices↗
PubMed1984

Endoscopy in the diagnosis of gastritis. Diagnostic value of endoscopic criteria in relation to histological diagnosis.

Endoscopy of the stomach was performed in 152 consecutive patients alternately by two endoscopists, such that the non-examining endoscopist always followed the procedure via a teaching attachment. A fiberscope with a close-focusing optical system for magnification of the mucosa was used. The interobserver reliability of eleven predefined macroscopic criteria was analysed and these criteria were compared with the histological diagnosis for each gastric region (body, transitional zone, antrum). The percentage of agreement between the two observers ranged between 80% and 97% for all criteria except mucosal erythema (74, 68, 62%) and mucus covering (53, 61, 87%). A consideration of all three gastric regions reveals that only one macroscopic criterion (visibility of submucosal vessels) correlated significantly with the histological diagnosis (i.e. atrophic gastritis). Other macroscopic criteria that correlated significantly with the histological diagnosis were most often observed in the gastric body. Their positive predictive value, however, rarely exceeded 50 percent. Thus, even with the use of modern instruments, endoscopy is of limited value for the prediction of gastritis identified by histology.

Adolescent↗
PubMed1984

Nosocomial septicemia in patients undergoing sclerotherapy for variceal hemorrhage.

The data of 19 consecutive unselected patients undergoing emergency sclerotherapy who were admitted to a single intensive care unit throughout the course of one year, were analyzed retrospectively for clinical and bacteriological signs of septicemia after the first sclerotherapy session. Ten had fever and/or chills, and in six of these patients microorganisms were cultured from arterial blood or central venous catheter tips. The data show that about one-third of patients with liver cirrhosis and acute variceal hemorrhage undergoing emergency sclerotherapy may develop septic disease.

Adult↗
PubMed1984

[Endoscopic retrograde cholangiography in the diagnosis of liver diseases].

ERC is mainly used either for the investigation of extrahepatic cholestasis or for the evaluation of common bile duct stones. Contrary to non-invasive procedures in liver diseases (laboratory investigation, ultrasound, computer tomography), ERC is only indicated when the biliary system might be involved in the underlying process. In these cases application of ERC depends on the question whether optimal visualization of the biliary tree will further assist in the therapeutic management of the disease. In primary and secondary sclerosing cholangitis ERC is the diagnostic procedure of choice.

Adolescent↗
PubMed1983

[Cholesterol content of bile-duct stones].

The cholesterol content of bile-duct stones from 40 patients after cholecystectomy was compared with 22 gall-bladder stones. There were 18 (82%) cholesterol-rich stones (cholesterol content more than 60% of dry weight) among gall-bladder stones, but only 12 (30%) among bile-duct stones. Eight bile-duct stones (20%) contained fibrous material, a further seven (18%) had a cholesterol-rich nucleus and cholesterol-poor outer layer. These findings indicate that residual fibres or small migrated gall-bladder stones can form the nidus for the growth of choledochal stones. The cholesterol content of bile-duct stones did not correlate with the age of the patient, time since cholecystectomy or cholesterol saturation of hepatic bile.

Aged↗
PubMed1983

Bile acid pattern and cholesterol saturation of bile after cholecystectomy and endoscopic sphincterotomy.

The effect of endoscopic sphincterotomy on bile acid composition and cholesterol saturation of bile has been studied in cholecystectomized patients. Individual bile acids and biliary lipids were measured in hepatic bile of 13 cholecystectomized females aged 56.8 +/- 16.6 years more than 9 months (mean 16.7 +/- 8.8 months) after sphincterotomy and of 12 cholecystectomized females aged 59.3 +/- 11.5 years who served as controls. The sphincterotomy group exhibited a significantly (p less than 0.01) higher percentage of chenodeoxycholic acid in bile--39.2 +/- (SD) 7.7%--than the controls with cholecystectomy only (29.1 +/- 7.4%), but showed no differences in the proportion of cholic acid (32.4 +/- 6.2 vs. 33.6 +/- 7.8%). The percentages of the secondary bile acids, deoxycholic acid (25.0 +/- 8.8 vs. 32.3 +/- 8.3%), and lithocholic acid (1.7 +/- 0.8 vs. 2.6 +/- 2.3%) were lower, but these differences were not statistically significant. The biliary lipid composition in the sphincterotomy group was not different from that in the controls, resulting in a similar cholesterol saturation index in both groups (1.87 +/- 0.60 vs. 2.02 +/- 0.60 according to Carey and Small; 1.45 +/- 0.32 vs. 1.55 +/- 0.32 according to Hegardt and Dam). These findings do not demonstrate any alterations of the bile composition after sphincterotomy which may be expected to have undesirable effects on the biliary and/or gastrointestinal system.

Adult↗
PubMed1983

Effect of endoscopic sphincterotomy on bile acid pool size and bile lipid composition in man.

The effect of endoscopic sphincterotomy on bile acid pool size and lipid composition was studied in 3 patients with an intact gallbladder and in 7 patients who had previous cholecystectomy. Measurements were made at two time intervals after endoscopic sphincterotomy, early (3-9 days) and late (6-9 months). Patients with an intact gallbladder showed a marked reduction in their total bile acid pool during follow-up examinations (95.3 +/- SD 14.0 vs. 18.6 +/- 8.1 mumol/kg), whereas in the cholecystectomized patients the pool size showed no significant change (29.4 +/- 13.4 vs. 26.6 +/- 11.4 mumol/kg). The reduction in bile acid pool size caused by sphincterotomy in patients with an intact gallbladder did not increase the degree of cholesterol saturation in hepatic bile.

Aged↗
PubMed1982

Sclerotherapy of a bleeding duodenal varix.

A case of successful treatment of a bleeding duodenal varix in a patient with portal hypertension and compensated cryptogenic cirrhosis (Child A) is reported. The 42-year-old man had a history of recurrent gastrointestinal hemorrhage over 14 years. In 1966 he underwent a portocaval shunt operation. Angiography in 1968 revealed a thrombosis of the shunt as well as of the splenic vein. Splenectomy was performed because of hypersplenism. In 1980 bleeding from esophageal varices occurred and was treated by sclerotherapy. Seven weeks after sclerotherapy massive bleeding from a duodenal varix occurred. Sclerotherapy of the duodenal varix via a flexible endoscope proved successful. Since then, during a follow-up period of 15 months, the patient has had no further bleeding episodes.

Adult↗
PubMed1982

Esophageal function after sclerotherapy of bleeding varices.

To study the effect of sclerotherapy of varices on esophageal function, the motility of the tubular esophagus and of the lower esophageal sphincter (LES) were recorded in 19 patients after 7 to 13 sclerotherapy sessions and in 15 healthy volunteers. In addition, esophageal functional scintigraphy (EFS) was performed in the patient group. Compared with the volunteers the patients had lower contraction amplitudes in the distal esophagus (30.5 +/- 17.5 mm Hg versus 43.6 +/- 9.1 mm Hg, p less than 0.01) and a higher percentage of non-propulsive simultaneous contractions (NPC) in the distal (33.4 +/- 23.2% versus 9.0 +/- 8.6%, p less than 0.005) and mid-esophagus (15.0 +/- 8.2% versus 8.3 +/- 8.1%, p less than 0.05). There was a negative correlation between the percentage of NPC in the distal and mid-esophagus and radionuclide transit (rs - 0.53, p less than 0.02). Three of 19 patients had a positive reflux index by EFS. The LES tone was only slightly lower in the patients than in the controls (10.7 +/- 3.2 mm Hg versus 13.4 +/- 3.6 mm Hg, p less than 0.05). Our findings indicate that sclerotherapy of esophageal varices may lead to a reduced peristaltic esophageal motility with an impaired transport function. This could contribute to the development of dysphagia or esophagitis.

Adolescent↗