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Biomedical subjects

U Leuschner

Publications and source records attributed to U Leuschner.

At least 109 records · Page 6Linked to original sources
PubMed1982

[Combined irrigation and endoscopy in the treatment of biliary duct stones (author's transl)].

In ten patients with biliary duct stones reoperation was not indicated and endoscopical stone extraction after papillotomy had failed due to the size of the concrements. As in some patients cholecystectomy had been performed several years ago and in others had not been done yet, treatment was commenced via an endoscopically inserted nasobiliary tube using media dissolving cholesterol and calcium bilirubinate stones. Results of treatment were satisfactory and side effects were tolerable. Results were compared with those after treatment with glycero-1-monooctanoate (Capmul 8210). In four patients distribution in the intra and extrahepatic biliary duct system was investigated by admixture of radiographically opaque media with both irrigation fluids. It was shown that both the oily and watery phase of the irrigation media were distributed homogeneously in the duct system and that the stone surface was covered adequately.

Aged↗
PubMed1982

[Clinical features of inflammatory bowel disease (author's transl)].

Inflammatory bowel disease may be caused by virus, bacteria, fungus, parasites or mechanical conditions. Among the inflammatory bowel diseases caused by bacteria salmonellosis and cholera are most important. Their treatment has been revolutionized within the last decade. Instead of the administration of antibiotics the usage of fluids, glucose and electrolytes represents the method of choice. Using the so called "traveller's disease" as an example the pathophysiological aspects of the treatment may be best explained. Etiology and pathogenesis of Crohn's disease, the incidence of which seems to be increasing lately, are still unknown. Before onset of treatment it is essential to establish an exact diagnosis, further to determine distribution and inflammatory activity, as those control the therapy. Salazosulphapyridine and steroids have proved effective drugs. Azathioprine should only be used combined with steroids. Recent investigations suggest that certain formula diets, such as e. g. Survimed, may be useful in the management of the disease as well.

Azathioprine↗
PubMed1982

Gallstone dissolution in the biliary tract: in vitro investigations on inhibiting factors and special dissolution agents.

Investigations of four bile duct stones demonstrated that the distribution of organic compounds, pigments, and crystalline calcium salts as well as the stone architecture can prevent dissolution with perfusion therapy. We describe perfusion media that will dissolve or disaggregate the substances mentioned in vitro. Isolated organic compounds, probably mucoproteins, could be disaggregated with a SH-activated enzyme-containing bile salt-EDTA-solution (BA-EDTA) at pH 6.5-8.2. After admixture of 5-10% glyceryl-1-monooctanoin-carnosine to the BA-EDTA solution a mucoprotein-rich pigment concrement (calcium-bilirubinate stone) was completely disaggregated and the calcium and pigment portion was dissolved within 36 h. Alternating administration of an enzyme-free BA-EDTA solution with glyceryl-1-monooctanoin-carnosine resulted in accelerated dissolution of a pigment containing cholesterol stone compared to CApmul 8210. These perfusion media have been successfully used in patients. Factors limiting stone dissolution remain stone architecture, crystalline carbonic occlusions in high concentration, and the topography of the biliary tree.

Bile Acids and Salts↗
PubMed1982

[Expected costs in the conservative and surgical treatment of uncomplicated cholecystolithiasis].

Three therapeutic strategies are possible in a patient with asymptomatic or mildly symptomatic cholesterol gallstones: Cholecystectomy, medical gallstone dissolution, and expectant attitude. The course of cholelithiasis under these three strategies was evaluated by three decision trees. The incidences of possible complications were taken from the literature. For every complication the costs of drugs, absenteeism, treatment as outpatient and inpatient were listed. The costs multiplied by the likelihood of the complication represent the expected costs of the complication under consideration. The sum of the costs due to the initial treatment and the expected costs of all possible complications corresponds with the expected average costs of a therapeutic strategy. It is 21 000,- DM with medical gallstone dissolution, 25 000,- DM with immediate cholecystectomy, and 27 000,- DM with expectant attitude, respectively. Gallstone dissolution becomes more expensive than cholecystectomy only when its efficacy drops below 40%. The data show that the costs are less important for the choice of the therapy in cholelithiasis. The advantage of the decision tree lies in the fact that it describes the history and the costs of a disease by figures. Thereby, disagreement on the effects of a therapy on the course of the disease can be analysed and discussed more distinctly.

Cholecystectomy↗
PubMed1982

Sex differences in rat liver bile acids.

Male Wistar rats show higher relative liver weights and higher weights of mitochondrial and microsomal fractions than females. Their relation of subcellular fraction weights tends more to the microsomal side. In liver homogenate and subcellular compartments, males contain significantly higher concentrations of beta-muricholic acid and other metabolites of chenodeoxycholic acid, females higher proportions of chenodeoxycholic acid. Higher concentrations of potentially toxic nonsulphated dihydroxy bile acids in the liver of female rats could be a sign of slower elimination, and the cause of higher susceptibility of females to liver injury induced by bile acid administration.

Animals↗
PubMed1981

Beneficial effect of somatostatin in phalloidin-intoxicated rats. Influence on survival rate, biochemical and morphological data, and 3H-demethylphalloin absorption rate by the liver.

The effect of somatostatin in phalloidin-intoxicated rats was studied. Animals were given phalloidin i.p. 1.2 mg/kg (LD 90-100). Somatostatin, 250 microgram/animal, was administered i.p. in saline 5 min prior and s.c. in protamine-sulphate/ZnCl2 suspension 30 min prior and 30 min after intoxication, unless stated otherwise. In vivo and in vitro uptake studies of the toxin were performed. Liver enzymes (GPT, GLDH) and kallikrein-like activities were determined in blood obtained by orbital venipuncture. Light and electron microscopy was carried out. Somatostatin treatment led to an increase in survival rate. Of the 20 treated rats six died whereas of the 20 untreated animals 18 died. A dose dependency was proven effective when half of the initial dose of somatostatin was given. In vivo and in vitro uptake studies of the toxin demonstrate that somatostatin does not alter uptake rate by rat livers. Liver enzymes remained elevated in treated and control rats. Kallikrein-like activities showed a 61% decline in treated animals whereas they rose up to 120% in controls as compared to pretreatment conditions. Light and electron microscopy reveals less severe lesions in somatostatin-treated animals. A possible interaction of somatostatin in shock development is discussed, phalloidin seems to be a suitable tool for further investigations concerning cell protection by somatostatin.

Alanine Transaminase↗
PubMed1981

Alternating treatment of common bile duct stones with a modified glyceryl-1-monooctanoate preparation and a bile acid-EDTA solution by nasobiliary tube.

Twenty patients with bile duct stones were treated via an indwelling nasobiliary tube with a modified Capmul 8210 preparation (GMOC) and alternating with a bile salt-EDTA (BA-EDTA) solution for an average of 12 days. In vitro the dissolution capacity of GMOC and BA-EDTA for cholesterol stones was higher than that of Capmul 8210. The nasobiliary tube was tolerated well for a maximum of 84 days; this renders us independent of the T-tube. The therapeutic success rate of GMOC was 64%, even though we treated mostly old and large concrements. Side effects occurred markedly less than with Capmul 8210. In patients with acute cholecystitis or cholangitis the clinical course improved under therapy, and there was no deterioration of a chronic condition.

Aged↗
PubMed1981

[Use development of sedatives/hypnotics and psychopharmaceuticals in the DDR with international comparisons using defined daily doses (DDD)].

For the period from 1965 to 1978, the development of the use of sedatives/hypnotics, tranquilizers, neuroleptics and antidepressives within one territory of the GDR is presented in a detailed manner. Besides this information about the trend the present stage of the consumption of centrally active pharmaceuticals, their DDD-values (defined daily doses) are given and international comparison with the development in Scandinavian countries are made.

Antidepressive Agents↗
PubMed1981

[Peritoneoscopy and liver biopsy in the diagnosis of liver disease (author's transl)].

In two prospective studies including 962 patients and one retrospective study including 165 patients the problem was investigated, to what extend ultrasonography might change the diagnostic value of clinical examination, peritoneoscopy, guided liver biopsy and blind liver biopsy. It turned out, that liver biopsy is the method of choice in diffuse-parenchymatous disease (e.g. chronic active hepatitis, chronic persistent hepatitis, fatty liver), whereas laparoscopy is to be preferred if focal lesions (e.g. liver carcinoma) are present. Diffuse liver disease was present in 80% of the cases investigated; in this group of patients the diagnostic value of blind biopsy is equivalent to the diagnostic value of guided biopsy. Thus, blind biopsy does yield satisfactory results in most patients if it is possible to differentiate between diffuse and focal disease by ultrasonography. Such differentiation could be achieved in 77-98% of our cases, thus ultrasonography could intake a decrease in numbers of peritoneoscopies and an increase of blind liver biopsy.

Biopsy, Needle↗
PubMed1980

[Resolution of cholesterol-gallstone with a modified Capmul 8210-emulsion and with an EDTA solution (author's transl)].

Cholesterol stones in the bile duct may be resolved by applying Capmul 8210 (Cholesterol-caprylic acid ester) by way of T-drain or through a gastro-biliary tube. Results of in vitro experiments and a case reported do show, that an alternating irrigation with a specially prepared solution of glycerooctonate with bile salt-EDTA-solution will yield better results than Capmul 8210 alone. The advantage of this alternating therapy results from the fact, that calcium bilirubinate may be resolved in addition to the other components of the gallstones, and that side effects are rarer and less disturbing than side effects caused by Capmul 8210.

Anticholesteremic Agents↗
PubMed1980

[Clinical and neurophysiological findings in serum controlled diphenylhydantoin application - considerations on myotonic dystrophy therapy].

A report is given on the possible therapeutic influence of diphenylhydantoin on dystrophic myotonia. After studying the correlations of the clinical-neurological findings, EEG changes and electromyo-electroneurographic findings with respect to the DPH serum concentration, it was found that a long-term therapy is only indicated in individual cases and when the patient is taken thorough care of.

Adolescent↗