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Biomedical subjects

U Junge

Publications and source records attributed to U Junge.

At least 19 recordsLinked to original sources
PubMed1997

[Primary sclerosing cholangitis with chronic pancreatitis].

HISTORY AND CLINICAL FINDINGS: A 68-year old man with insulin dependent diabetes mellitus was admitted to hospital because of diarrhoea, general weakness and 10 kg weight loss over the preceding 3 months. Biliary tract enzymes were markedly elevated (alkaline phosphatase > 1000 U/l, gamma-glutamyl transferase > 300 U/l). Computed tomography (CT) was suggestive of a space occupying lesion in the head of the pancreas. INVESTIGATIONS: CT confirmed the space-occupying lesion and biopsy revealed chronic fibrosing pancreatitis. Radiology showed the typical picture of primary sclerosing cholangitis (PSC), in addition to inflammatory changes in the pancreatic duct. TREATMENT AND COURSE: Administration of ursodeoxycholic acid and substitution therapy for the exocrine and endocrine pancreatic insufficiency normalised the laboratory values. The patient gained 5 kg and the changes in the biliary tract and pancreatic ducts markedly regressed. CONCLUSION: PSC is rarely associated with inflammatory pancreatic changes, which cause severe functional changes. Ursodeoxycholic acid improves both the biochemical changes and the histological lesions of the biliary tract and the pancreatic ducts.

Aged↗
PubMed1994

[Endoscopic balloon dilatation of symptomatic strictures in Crohn's disease].

Between March 1990 and August 1993, eleven stenoses were dilated to a diameter of 25 mm by balloon catheter introduced through a coloscope in ten of 25 patients with Crohn's disease that had caused drug-resistant obstructions (five men, five women: mean age 45 [22-61] years). These patients had inactive Crohn's disease with 2-8 cm long stenoses in the rectum (n = 1), sigmoid colon (n = 2), terminal ileum (n = 2) or in the neoterminal ileum after a previous operation (n = 6). Nine of the eleven stenoses were successfully dilated, and seven of these eight patients continued to be pain-free during a follow-up period of 6-42 (average 17) months. The only complication was one case of bleeding. This experience indicates that endoscopic balloon dilatation is a valuable addition to surgical treatment in patients with inactive Crohn's disease associated with short, fibrotic stenoses.

Adult↗
PubMed1987

[Perforation of a stomach ulcer into the left heart ventricle. Case report and review of the literature].

We present a case of peptic-ulcer perforation from the stomach into the left ventricle. The patient who had no prior cardiac or abdominal symptoms was admitted with gastrointestinal bleeding and the electrocardiographic signs of myocardial infarction of the posterior wall. After the bleeding had subsided for 5 hours the patient died suddenly from massive upper gastrointestinal bleeding. At autopsy a peptic ulcer was found 3 cm beneath the cardia in the anterior wall on the lesser curvature which had perforated dorsal from the papillar muscle into the left ventricle. In the literature 19 such ulcer perforations have been reported which are compared with the present case.

Aged↗
PubMed1984

[Dissolution of recurrent stones in the choledochus by a modified irrigation treatment via an indwelling nasobiliary catheter].

Alternating fluid rinsing with a modified glyceromono-octanoate (GMOC) and bile salt-EDTA (BA-EDTA) solution via an endoscopically placed indwelling nasal biliary catheter was performed on 15 patients (13 women, 2 men) with recurrent stones in the choledochal duct after cholecystectomy. Of 12 radiotranslucent and three radioopaque concrements with a mean diameter of 1.72 X 2.05 cm (largest concrement: 3.0 X 3.5, smallest 1.0 X 2.1 cm) 13 were dissolved (87% success rate). In one patient chemolitholysis had to be stopped because of electrolyte abnormalities, before treatment had been completed. After the end of treatment all patients were free of symptoms and during a fairly long follow-up period no stone recurrences were observed.

Aged↗
PubMed1984

Pancreatic digestive function after subtotal gastrectomy--evaluation by an indirect method.

Digestive function of 24 patients with Billroth (BII) subtotal gastrectomy and gastrojejunostomy was investigated using an oral pancreatic function test with fluorescein-dilaurate as substrate (FDL-test). The FDL-test after Bll subtotal gastrectomy revealed maldigestion in 75% of the patients. The mean FDL-ratio (normal when higher than 30%) was 21.6 +/- 4.9% in Bll patients, compared with 62.2 +/- 6.9% in healthy controls (p less than 0.001). No correlation between such digestive complaints as dumping and diarrhoea and the FDL-test results was found. Although FDL-test results were abnormal in all patients with chronic pancreatitis, they were also found to be abnormal in 8 patients who did not have chronic pancreatitis. Consequently, the FDL-test cannot be used as a specific test for chronic pancreatitis after gastric operations. Since free fluorescein is normally absorbed after gastric resection, an abnormal FDL-test result indicates impaired pancreatic digestion, possibly due to delayed enzyme and/or poor intraluminal mixing.

Adult↗
PubMed1983

Ultrasound, computed tomography and endoscopic retrograde cholangiopancreatography in the morphologic diagnosis of pancreatic disease.

From February to November 1981 the diagnostic relevance of ultrasound (US), computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) was compared prospectively in 75 patients with suspected pancreatic disease. Final diagnosis was confirmed by autopsy, surgery, clinical course, and further laboratory data. Thus it was possible to exclude pancreatic disorders in 32 patients. By ERCP we diagnosed all tumors; sensitivity was 100%. Sensitivity of US and CT were 63% each. In five cases US made the false positive diagnosis" pancreatic malignant tumor" (specificity 93%), CT and ERCP in two cases (specificity 97% each). In chronic pancreatitis specificity of US and ERCP were 100% and specificity of CT was 98%. Sensitivity of ERCP amounted to 93%, CT and US revealed 74% and 52%, respectively. We conclude that ERCP is the best morphologic diagnostic tool in differentiating chronic pancreatitis from pancreatic carcinoma. US is a good screening method and CT reveals good diagnostic results in acute pancreatitis.

Adult↗
PubMed1983

[Oral pancreas function test with FDL in the diagnosis of chronic pancreatitis].

The diagnostic accuracy of a tubeless pancreatic function test--Pancreolauryl (PLT)--was evaluated on 97 patients and healthy controls: we found a pathological result of PLT in 31 (88.6%) of 35 patients with proven chronic pancreatitis and a normal PLT in 30 (90%) of 33 controls with no pancreatic disease. In 29 patients with a defined gastrointestinal disease other than chronic pancreatitis the test result was pathological in 51%. This result points towards a limited specificity of the PLT in this latter group, but shows its usefulness as an indicator for maldigestion accompanying the primary disease. In comparison to firmly established diagnostic means for chronic pancreatitis the PLT result was in accordance with the Secretin-Ceruletide function test in 81.3% with ERCP in 80.9% and with computertomography in 76.4%.

Ceruletide↗
PubMed1981

Trophic effect of protal blood in maintenance cultures of adult rat hepatocytes.

The hepatotrophic effect of portal serum was demonstrated in primary monolayer cultures of adult rat hepatocytes: DNA synthesis in cultures incubated for 4 days with pooled portal serum of fed rats was significantly higher than in cultures with peripheral serum from the same animals. This difference was not observed when portal blood was treated with charcoal or obtained from fasting rats. Portal serum from diabetic rats stimulated DNA synthesis less than portal control serum. The trophic effect of portal serum from normal rats was enhanced after tolbutamide injection. The lost tropic effect of charcoal-treated portal serum was completely restored when insulin was added to reobtain a normal portal immunoreactive insulin concentration. Thus, insulin seems to be the main factor responsible for the hepatotrophic action of portal blood in vitro.

Animals↗